Knowledge and practices of dentists in preventing infective endocarditis in children

Abstract

This preliminary study assessed the knowledge and practices of dentists in the prevention of infective endocarditis (IE). The study included 21 dentists working at two public hospitals in Brazil who cared for children with special needs who also have cardiac conditions. The data from a semistructured interview were processed for qualitative and quantitative analysis. All subjects defined IE correctly. Most subjects (81%) said they had treated patients with a previous history of IE and 7 (33%) stated that many guardians seemed to be afraid to mention that their child had a previous history of IE. The main risk of infectivity was the oral cavity according to 16 subjects (76%). Nine subjects (43%) considered a dental procedure involving any amount of bleeding as being a risk, and periodontal/endodontic treatments were mentioned by 5 (24%) as procedures that needed antibiotic prophylaxis. As for prophylactic treatment, only 7 subjects (33%) said they followed the American Heart Association guidelines. The authors concluded that the subjects' knowledge and practices in preventing IE were inadequate.

Current prescribing Practices for Antibiotic Prophylaxis: A Survey of Dental Practitioners

“…28 In addition, 14% of dentists felt there was not enough time to discuss with the patient risks vs benefits of antibiotic prophylaxis. 28 Finally, to avoid the overuse of antibiotics, 33% stated they performed multiple dental procedures during one appointment. 28 Lockhart et al 29 surveyed US dentists regarding their compliance with the 2007 AHA recommendations for antibiotic prophylaxis.…”

“…Of the 21 dentists, 33% stated they followed the 2007 AHA antibiotic prophylaxis guidelines. 28 A total of 33% of dentists stated they had offered an explanation about the risk associated with bacteremia and the patient's inadequate oral health. 28 In addition, 14% of dentists felt there was not enough time to discuss with the patient risks vs benefits of antibiotic prophylaxis.…”

“…28 A total of 33% of dentists stated they had offered an explanation about the risk associated with bacteremia and the patient's inadequate oral health. 28 In addition, 14% of dentists felt there was not enough time to discuss with the patient risks vs benefits of antibiotic prophylaxis. 28 Finally, to avoid the overuse of antibiotics, 33% stated they performed multiple dental procedures during one appointment.…”

“…However, 42% of the dentists stated they would prescribe antibiotic prophylaxis for patients with mitral valve prolapse (MVP) with regurgitation, which implied that some Israeli dentists were still following the 1997 AHA guidelines. 27 Coutinho et al 28 examined the knowledge and practices of dentists in preventing infective endocarditis in children. Of the 21 dentists, 33% stated they followed the 2007 AHA antibiotic prophylaxis guidelines.…”

“…[23][24][25][26][27][28][29] Lauber et al 23 surveyed Canadian dentists and family physicians and found that dentists were more familiar with the 2007 AHA antibiotic prophylaxis protocols than physicians in selecting the correct "first-line" antibiotic for prophylaxis. Jain et al 24 found that the majority of Canadian dentists (89.2%) and dental hygienists (89.9%) deferred antibiotic prophylaxis prescription decisions to the patient's cardiologist.…”