An update on infective endocarditis of dental origin

Objectives: The aim of this study was to analyse the prevalence of dental treatment and oral infections related to the development of infective endocarditis (IE). Methods: A retrospective study of 103 cases of IE diagnosed from 1997 to 1999 was conducted in Galicia, Spain. Results: According to the Duke's endocarditis criteria (19,94), 87 cases (84.5%) were considered definite IE. A presumed oral portal of entry was recorded in 12 patients (13.7%). Oral infections were held responsible in six cases while the remaining six had received dental treatment in the previous three months (three tooth extractions, one scaling, one cleaning, one fillings). In eight cases of IE (66.6%) typical oral pathogenic microflora was identified, with Streptococcus viridans being the most frequent. In four patients no previous cardiac disease was recorded. Conclusions: These results suggest that prevalence and characteristics of IE cases of dental origin did not change significantly in the last decades. The need for increased oral hygiene and improved dental care should be emphasized on preventing IE of dental origin. Continued education of physicians and dentists on the importance of the knowledge of current prophylactic protocols should also be considered. (C) 2002 Elsevier Science Ltd. All rights reserved.