Dentists Generally in Compliance With Prophylaxis Guidelines

Investigators report that dentists and oral surgeons are largely in compliance with American Heart Association (AHA) 2007 guidelines that only patients with cardiac conditions who are at moderate to high risk of developing infective endocarditis receive prophylactic antibiotics. Prior to 2007, the AHA recommended prophylactic antibiotics for all patients at moderate to high risk of developing the infection.

The study, “Effect of the American Heart Association 2007 Guidelines on the Practice of Dental Prophylaxis for the Prevention of Infective Endocarditis in Olmsted County, Minnesota,” examined dental records in the Rochester Epidemiology Project, a collaboration of medical and dental providers in Minnesota and Wisconsin that links research data for medical, dental and surgical procedures, prescriptions and other health care information.

Published in Mayo Clinic Proceedings, the paper examined dental records of 1351 adults (1236 at moderate risk and 115 at high risk of developing infective endocarditis) who received dental care in Olmsted County from 2005 through 2015. The researchers note a reduction in antibiotic prophylaxis in the moderate-risk group before invasive dental procedures, as rates dropped from 64.6% before the 2007 guideline update to 8.6% after the update. Among the high-risk cohort, rates dropped from 96.9% pre-2007 to 81.3% post-2007.

“Using the Rochester Epidemiology Project, we have shown that the AHA guidelines were helpful in reducing unnecessary antibiotic use and related issues, without an increase in new cases of infective endocarditis,” says Daniel DeSimone, MD, lead author of the study and an infectious diseases and hospital internal medicine physician at Mayo Clinic.

From Decisions in Dentistry. July 2017;3(7):11.