By: Danielle Duncan

Endocarditis, caused by a bacterial infection,is a rare, life-threatening inflammation of the heart and its valves. While most common in people with existing heart conditions, it can be found in anyone, and can sometimes be caused by poor dental hygiene, especially in patients who have underlying health conditions. 

In some rare cases, bacteria found in plaque can multiply and turn to gingivitis (gum disease), and if left untreated, may become advanced and enter the bloodstream when the gums begin to bleed. This condition is called infective endocarditis. Once inside the bloodstream, it can begin to infect other parts of the body, including the heart and the surfaces of its valves. 

When most people think about heart conditions, the last thing they would consider is if their everyday oral healthcare routine (or lack thereof), could be putting their health in jeopardy. This is why it is incredibly important that dental professionals get their patients on board in keeping their smiles in tip-top condition.

According to the American Heart Association, one of the biggest causes of infective endocarditis is poor oral hygiene, gum injury, and dental procedures if infection is present and mitigation steps aren’t taken prior, during, and after treatment in those at most risk. 

As the famous saying from Benjamin Franklin goes, an ounce of prevention is worth a pound of cure. While he was originally referring to house fire prevention, it is applicable in prevention of endocarditis caused by bacteria in the mouth as well.

Your body is your most important home, and keeping it safe from preventable fires by maintaining a daily routine of brushing, flossing, using mouthwash, and maintaining a regular semi-annual dental appointment is too simple to be ignored.

Regular dental visits and good dental care are linked to lower risk of heart disease, according to the American College of Cardiology and in a study published by the European Heart Journal in 2019, they reported that adults who kept up with routine brushing of at least twice per day had a 9% reduced risk of cardiovascular problems, as well as those who visited their dentist at least annually, had a 14% reduced risk. 

Fortunately, even if your patient hasn’t kept up on their oral hygiene routine, all isn’t lost. As dental professionals, we know how important it is to provide continued education and guidance for patients and keep them updated on the state of their oral health and the risks involved in ignoring routine.

In some cases, it is recommended to use small doses of prescribed antibiotics before dental procedures. However, that doesn’t mean that all patients with cardiac risk should be treated with antibiotics before every procedure. There are only four categories of heart patients who should be treated with antibiotics during certain procedures:

• Patients with prosthetic material used for valve repair or those with fully prosthetic valves. 
• Patients with a previous case of infective endocarditis.
• Children and adults with congenital heart disease. 
• People who have had a heart transplant. 

While it may be tempting to treat all heart patients with antibiotics before each procedure just to play it safe, antibiotic resistance carries with it, its own risks, which should be balanced carefully with the oral treatment of patients. 

The fact of the matter is, the most important part of preventing endocarditis caused by poor oral health, is to get your patients on board with practicing good oral hygiene. 

If your patients are hesitant to get the care they need because of financial pressure, you can help relieve that by adding medical billing into your dental practice. With a more affordable visit, patients will be far more willing to take their whole body health into their hands by sticking to annual or semi-annual dental visits. 

How do you help your patients reduce the risk of endocarditis?