Since March of 2008, dentists have not been free to give patients antibiotics before invasive procedures, if the patients are at risk of developing a life threatening heart infection called infective endocarditis. 40% of infective endocarditis cases are caused by bacteria in the mouth. These regulations came from the National Institute for Health and Care Excellence (NICE).
It was initially unclear what the impact of these guidelines was. The University of Sheffield found that in 2013 there was an increase in infective endocarditis by 35 cases per month from what was expected. Antibiotic prophylaxis prescriptions feel from 10,900 prescriptions per month to 1,235 per month (an 89% decrease).
It appears that those at highest risk of infective endocarditis are:
- Patients that have previously had endocarditis
- Cardiac transplant recipients who’ve developed cardiac valve abnormalities
- Patients with a prosthetic cardiac valve
- Those with congenital heart disease for unrepaired cyanotic congenital heart disease, including palliative shunts and conduits; completely repaired congenital heart defect with prosthetic material or device, during the first six months after the procedure; or repaired congenital heart disease with persisting leaks or abnormal flow at the site or adjacent to the site of a prosthetic patch or prosthetic device