The Medical Letter on Drugs and Therapeutics
Endocarditis Prophylaxis for Dental Procedures
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Revised 10/2/12: In the Dental Procedures paragraph, 6th line, the word “rubber” has been omitted before the word “bands” because placement of rubber bands does not require prophylaxis; placement of orthodontic metal bands does.

Since 2007, antimicrobial prophylaxis for dental procedures has been recommended only for patients at highest risk of severe consequences from infective endocarditis.1 There is no indication that more limited use of dental prophylaxis since then has led to an increase in the incidence of infective endocarditis.2,3

HIGHEST-RISK PATIENTS — The risk of severe consequences from endocarditis after dental procedures is highest in patients with previous infective endocarditis, prosthetic heart valves, or unrepaired cyanotic congenital heart disease such as tetralogy of Fallot, including those with surgically constructed palliative shunts or conduits. Patients are also considered at highest risk during the first 6 months after repair of congenital heart defects with prosthetic material or a prosthetic device, at any time after a congenital heart repair ... more      

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Title: Endocarditis Prophylaxis for Dental Procedures
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