Guidelines for the just in case use of antibiotics before invasive dental work need to be reviewed, according to a recent study.
Brian Strom and colleagues of the University of Pennsylvania in America studied 273 patients with community acquired infective endocarditis (inflammation of the lining of the heart). Over a three month period, an equal number of those who did and did not have dental work contracted the disease. No specific dental procedure was associated with the development of endocarditis, with the exception of tooth extraction. However, Strom points out, this procedure was so uncommon (there were only six cases in his study group) that a full evaluation of its link with the disease was not possible.
Under current US guidelines, some 10 per cent of the population should receive prophylactic antibiotics when having a dental procedure. Even assuming 100 per cent effectiveness, the authors say few cases of endocarditis would be prevented (Ann Intern Med, 1998; 129: 761-9).