Procedures for which endocarditis prophylaxis is recommended

Dental procedures requiring endocarditis prophylaxis include:

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• Routine teeth cleaning at the dentist's office
• Dental extractions
• Periodontal procedures including surgery, scaling, and root planing, probing, and recall maintenance
• Endodontic (root canal) instrumentation or surgery
• Subgingival placement of antibiotic fibers or strips
• Initial placement of orthodontic bands but not brackets
• Intraligamentary local anesthetic injections
• Prophylactic cleaning of teeth or implants

Respiratory tract procedures requiring endocarditis prophylaxis include:

• Tonsillectomy and/or adenoidectomy
• Surgical operations that involve respiratory mucosa
• Bronchoscopy with a rigid bronchoscope

Gastrointestinal procedures requiring endocarditis prophylaxis:

• Exams or treatments with instruments including sclerotherapy for esophageal varices, esophageal stricture dilation, endoscopic retrograde cholangiography with biliary obstruction
• Surgical procedures including Biliary tract surgery, colon resection, operations that involve intestinal mucosa, hemorrhoid removal, polyp removal, or colon resection.

Genitourinary procedures requiring endocarditis prophylaxis:

• Procedures including surgeries of the prostrate, bladder, gallbladder
• Exams or treatments with instruments including cystoscopy, urethral dilation

Individuals can do several things daily to guard against an endocarditic infection:

• Use good oral hygiene.
• Routinely brush and floss teeth and gums, and get regular checkups.
• Cuts or lesions should be cleaned thoroughly and watched for signs of infection. A physician should be contacted if a cut or lesion is not healing well or looks infected.

Although physicians and dentists are aware that people who are susceptible to bacterial endocarditis should be given antibiotics prophylactically prior to procedures, it is a good idea to inform or remind your doctor or dentist of congenital heart disease before any dental, surgical, or special procedures is done. The American Heart Association has a wallet-sized card designed for this purpose that can be obtained from its website.