Dental procedures in children with severe congenital heart disease: a theoretical analysis of prophylaxis and non-prophylaxis procedures

Objective-To estimate the cumulative exposure to bacteraemia from dental procedures currently recommended for antibiotic prophylaxis and compare this with cumulative exposure from dental procedures not recommended for prophylaxis. Design-Retrospective analysis. Setting-University and teaching hospital maxillofacial and dental department. Patients-136 children with severe congenital cardiac disease attending for dental treatment between 1993 and 1998 and for whom full records were available. Each dental procedure was tallied. Main outcome measures-Cumulative exposure per annum to "non-prophylaxis procedures"; cumulative exposure per annum to "prophylaxis procedures". Results-Cumulative exposure to bacteraemia from prophylaxis procedures was nor significantly greater than from non-prophylaxis procedures. Conclusions-The data raise important questions about the appropriateness of current guidelines for antibiotic prophylaxis of bacterial endocarditis.