title: Acceptance among and impact on dental practitioners and patients of American Heart Association recommendations for antibiotic prophylaxis.
abstract: BACKGROUND
  The 2007 American Heart Association (AHA) guidelines for the prevention of infective endocarditis (IE) called for a major reduction in the number of patients recommended for antibiotic prophylaxis (AP) and redefined the dental procedures considered to put these patients at risk of acquiring the infection. The purpose of the authors' study was to determine the acceptance of these changes among and the impact of the changes on dentists and their patients.
  
  
  METHODS
  The authors sent a survey to a random sample of 5,500 dentists in the United States.
  
  
  RESULTS
  Ninety-five percent of the 878 respondents indicated that they saw patients who receive AP. More than 75 percent were either satisfied or very satisfied with the AHA guidelines, and the respondents indicated that they believed almost three-quarters of their patients also were pleased. Seventy percent of dentists, however, had patients who took antibiotics before a dental procedure even though the guidelines no longer recommend it.
  
  
  CONCLUSIONS
  Acceptance of the 2007 guidelines appears to be high, but controversy remains. Additional scientific data are needed to resolve these issues.
  
  
  CONCLUSIONS
  The 2007 AHA guidelines have greatly simplified the identification of patients who need AP for dental procedures, given that, in general, far fewer people with cardiac abnormalities are considered to be at risk as a result of invasive procedures. Some physicians, however, continue to prescribe antibiotics for some patients whom the AHA no longer considers to need them. Patients also may choose to continue this practice themselves. There is ongoing controversy surrounding this common clinical question in dental practice, and the next guidelines from the AHA may change on the basis of data from future clinical studies.
authors.affiliation: Department of Oral Medicine, Carolinas Medical Center, 1000 Blythe Blvd., P.O. Box 32861, Charlotte, N.C. 28232-2861, USA. Peter.Lockhart@carolinashealthcare.org
authors.forename: Peter B
authors.initials: PB
authors.lastname: Lockhart
authors.forename: Nicholas B
authors.initials: NB
authors.lastname: Hanson
authors.forename: Helen
authors.initials: H
authors.lastname: Ristic
authors.forename: Adriana R
authors.initials: AR
authors.lastname: Menezes
authors.forename: Larry
authors.initials: L
authors.lastname: Baddour
mesh_terms: D000328:Adult; D000368:Aged; D000572:American Heart Association; D019072:Antibiotic Prophylaxis; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D003729:Dental Care; D003815:Dentists / Q000523:psychology*; D004697:Endocarditis, Bacterial / Q000517:prevention & control; D005260:Female; D005792:General Practice, Dental; D019983:Guideline Adherence; D006331:Heart Diseases / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged; D008945:Mitral Valve Prolapse / Q000150:complications; D010549:Personal Satisfaction; D017410:Practice Guidelines as Topic; D014481:United States
keywords: Antibiotic prophylaxis; bacteremia; bacterial infection; cardiovascular diseases; clinical protocols; consumer satisfaction; dental prophylaxis; endocarditis; infective; medically compromised patients; special-care dentistry