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

Heart. 2001 Jan;85(1):66-8. doi: 10.1136/heart.85.1.66.

Abstract

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 not 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.

MeSH terms

  • Adolescent
  • Adult
  • Antibiotic Prophylaxis / standards*
  • Child
  • Child, Preschool
  • Endocarditis, Bacterial / etiology
  • Endocarditis, Bacterial / prevention & control*
  • Female
  • Guidelines as Topic
  • Heart Defects, Congenital / complications*
  • Humans
  • Male
  • Oral Surgical Procedures / adverse effects
  • Oral Surgical Procedures / standards*
  • Periodontics / standards*
  • Retrospective Studies
  • Tooth Diseases / complications
  • Tooth Diseases / therapy*