What Parents Should Know About Endocarditis & Antibiotics

Bacterial endocarditis is an infection caused by bacteria that enter the bloodstream and settle in the heart lining or heart valves. Bacteria can enter the bloodstream in many ways. One common way is through infectious teeth (cavities) or gums. Poor dental hygiene can cause bacteremia bacteria in the blood). Any professional dental treatment that causes bleeding – such as a cleaning, repairing or removing teeth – can also allow bacteria to enter the bloodstream.

Usually bacteria entering the bloodstream circulate through the body and are destroyed by normal body defenses. Sometimes, however, bacteria find a place to settle, and an infection starts. When the infection is in the heart, it is called endocarditis.

Children with congenital heart problems – even minor problems – have a greater risk of developing endocarditis when bacteria enter the bloodstream. Endocarditis can seriously damage the heart. Therefore, these children need additional protection to help normal body defenses destroy bacteria before they can infect the heart.

Basic prevention can start at home with careful dental care. Anyone at risk for endocarditis should be especially careful about daily brushing and flossing to maintain healthy teeth and gums.

Antibiotics given immediately before teeth cleaning (or other procedures which cause bacteremia) protect against infection. This is called SBE prophylaxis: protection against sub-acute bacterial endocarditis. Individuals at risk should receive this protection each time they have a procedure that increases their risk of bacteremia. The goal of antibiotics is to provide short-term protection. Usually, one dose of an antibiotic is given one hour before the procedure. This provides protection at the time it is needed, but limits the child’s exposure to antibiotics.

Teeth cleaning, tooth extraction and initial placement of orthodontic bands require pre-medication. Surgery for PE (“ear tubes”) does not require pre-medication.

For the most up to date information and guidelines please visit
The American Heart Association

Cheryl Kelley, DMD Pediatric Dentistry | 370 White Spruce Blvd. | Rochester, NY, 14623
Phone: (585) 424-5005 | Fax: (585) 475-0096 | e-mail: info@asmiletogrowwith.com