The guidelines for the prevention of infective endocarditis (IE) issued by the American Heart Association underwent a major revision in 2007. Key changes include the following:
Dental procedures have been found to be associated with a very small number of cases of IE. Prophylaxis, even if 100% effective, would thus prevent only an extremely small number of cases.
The emphasis has shifted from use of antibiotic prophylaxis to good oral health and increased access to dental care.
Prophylactic antibiotics based on a patient’s lifetime risk for acquiring IE are no longer recommended. Instead, prophylaxis focuses on patients with the highest risk for adverse outcomes from endocarditis.