Acute infective endocarditis due to dental related infection: Systematic review
1 Dental Resident, Family Dentistry Department, National guard health affairs King Abdulaziz medical city-Riyadh.
2 Emergency Medical Services, National guard health affairs.
3 Cardiac Sciences, National guard health affairs.
4 Nursing National guard hospital.
5 Emergency Medical Services National guard hospital.
Review Article
World Journal of Advanced Research and Reviews, 2024, 24(01), 2817–2823
Publication history:
Received on 24 September 2024; revised on 27 October 2024; accepted on 29 October 2024
Abstract:
Background: The causal link between oral sources, particularly invasive dental procedures (IDPs) and poor oral health, and acute infective endocarditis (IE) is debated despite evolving guidelines. Objective: To synthesize original human data on IE episodes attributable to dental sources (microbiologically consistent organisms and/or temporal relation to dental exposure). Methods: Following PRISMA guidance, we searched MEDLINE/PubMed, Embase, Web of Science, and Cochrane (inception–October 20, 2025; no language limits), screened references, and included original human studies reporting IE with dental exposure (recent IDPs or odontogenic infection) and/or oral streptococcal (VGS) etiology. Outcomes were IE incidence/risk after IDPs, organism profiles, and outbreak descriptions. Results: Thirteen studies met criteria: 6 analytic epidemiologic studies (case-control/case-crossover/cohort), 3 population-level time-series/registry analyses, 1 oral-health risk study, 1 public-health outbreak investigation, and 2 clinical observational studies. Evidence is mixed overall: large modern studies show a temporal association between IDPs and IE among high-risk patients and suggest antibiotic prophylaxis (AP) reduces post-IDP IE in this group, while older case-control/case-crossover studies and some contemporary analyses show no association in unselected populations. Conclusions: Dental sources, especially extractions/oral surgery, increase IE risk in high-risk cardiac patients, while population-wide risk appears small. Emphasis on oral hygiene and targeted AP aligned with AHA/ESC guidance is supported; additional prospective data are needed to refine indications.
Keywords:
Infective Endocarditis; Dental Procedures; Viridans Streptococci; Antibiotic Prophylaxis; Oral Hygiene; Outbreak
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