For dental procedures only a small number of cases may be prevented by antibacterial prophylaxis.
Risk of adverse effects from antibiotics frequently outweigh possible benefits.
Infectious endocarditis is more likely to occur from the bacteria released during daily dental hygiene events, such as bruising or flossing than during any given dental procedure.
Over the course of a year the release of bacteria during daily activities may be as high as 5.6 million times greater than during a single tooth extraction, which is the dental procedure reported to cause the greatest release of bacteria.
Maintaining optimal oral health and practicing daily oral hygiene are more important in reducing the risk of infectious endocarditis than taking preventative antibiotics before a dental visit.
Recommended for patients prior to dental procedures involving gingival tissue manipulation, or apical region of teeth or perforation of the oral mucosa in patients with artificial cardiac valves, previous infective endocarditis, congenital heart disease with unrepaired cyanotic congenital heart diseases with shunts and conduits, completely repaired congenital heart defect with prosthetic material or device during the first 6 months after the procedure, any repaired congenital heart disease with residual defects at the site or adjacent to the site of a prosthetic patch or prosthetic device and in cardiac transplantation patients who develop a cardiac valvulopathy.
No longer recommended for mitral valve prolapse, rheumatic heart disease bicuspid valve disease, calcified aortic stenosis, and congenital heart conditions such as ventricular septal defect, atrial septal defect and hypertrophy cardiomyopathy.
Not recommended for patients with previous coronary artery bypass surgery, cardiac pacemakers, and implanted defibrillators.