Dental procedures in children with severe congenital heart disease: a theoretical analysis of prophylaxis and non-prophylaxis procedures.
OBJECTIVE
To estimate the cumulative exposure to bacteraemia from dental procedures currently recommended for antibiotic prophylaxis and compare this with cumulative exposure from dental procedures not recommended for prophylaxis.


METHODS
Retrospective analysis.


METHODS
University and teaching hospital maxillofacial and dental department.


METHODS
136 children with severe congenital cardiac disease attending for dental treatment between 1993 and 1998 and for whom full records were available. Each dental procedure was tallied.


METHODS
Cumulative exposure per annum to "non-prophylaxis procedures"; cumulative exposure per annum to "prophylaxis procedures".


RESULTS
Cumulative exposure to bacteraemia from prophylaxis procedures was not significantly greater than from non-prophylaxis procedures.


CONCLUSIONS
The data raise important questions about the appropriateness of current guidelines for antibiotic prophylaxis of bacterial endocarditis.
Al-Karaawi
Z M
ZM
Department of Paediatric Dentistry, Eastman Dental Institute, University College London, 256 Gray's Inn Road, London WC1X8LD, UK.
Lucas
V S
VS
Gelbier
M
M
Roberts
G J
GJ
D000293:Adolescent; D000328:Adult; D019072:Antibiotic Prophylaxis / Q000592:standards*; D002648:Child; D002675:Child, Preschool; D004697:Endocarditis, Bacterial / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D017408:Guidelines as Topic; D006330:Heart Defects, Congenital / Q000150:complications*; D006801:Humans; D008297:Male; D019647:Oral Surgical Procedures / Q000009:adverse effects / Q000592:standards*; D010517:Periodontics / Q000592:standards*; D012189:Retrospective Studies; D014076:Tooth Diseases / Q000150:complications / Q000628:therapy*