title: Antibiotic prophylaxis for infective endocarditis: Knowledge and implementation of American Heart Association Guidelines among dentists and dental hygienists in Alberta, Canada.
abstract: BACKGROUND
  Knowledge and interpretation of the 2007 American Heart Association (AHA) guidelines regarding infective endocarditis (IE) prophylaxis among the dental community is not well established. The authors' aim was to determine how dentists and dental hygienists interpret the 2007 AHA guidelines.
  
  
  METHODS
  The authors sent a cross-sectional survey to a random sample of 450 dental hygienists and 450 dentists in Alberta, Canada. The survey ascertained whether the practitioner would recommend IE prophylaxis to a high-risk cardiac patient undergoing a variety of dental procedures and for a variety of cardiac lesions in patients requiring gingival manipulation.
  
  
  RESULTS
  One hundred forty-nine hygienists (33%) and 194 dentists (43%) completed the survey. Use of prophylaxis for specific dental procedures was heterogeneous; 43% of hygienists recommended prophylaxis for polishing, 46% did not, and 11% replied "sometimes." Hygienists were more likely than dentists to inappropriately recommend IE prophylaxis for low-risk lesions including mitral valve prolapse (54% of hygienists versus 42% of dentists recommending prophylaxis; P = .037) and hypertrophic cardiomyopathy (23% versus 15%; P = .057). The authors also observed a failure to recommend IE prophylaxis for high-risk lesions, including mechanical valve (that is, 81% of hygienists and 91% of dentists recommending prophylaxis; P = .008).
  
  
  CONCLUSIONS
  There is heterogeneity within the dental community with respect to IE prophylaxis. Dental hygienists are more likely than dentists to recommend IE prophylaxis for low-risk cardiac lesions. Both dentists and hygienists did not consistently recommend prophylaxis for all high-risk cardiac lesions.
  
  
  CONCLUSIONS
  Greater emphasis on IE prophylaxis education is required in training programs and continuing professional development.
authors.forename: Pankaj
authors.initials: P
authors.lastname: Jain
authors.forename: Thomas
authors.initials: T
authors.lastname: Stevenson
authors.forename: Alexandra
authors.initials: A
authors.lastname: Sheppard
authors.forename: Kathryn
authors.initials: K
authors.lastname: Rankin
authors.forename: Sharon M
authors.initials: SM
authors.lastname: Compton
authors.forename: William
authors.initials: W
authors.lastname: Preshing
authors.forename: Ross
authors.initials: R
authors.lastname: Anderson
authors.forename: Sunjidatul
authors.initials: S
authors.lastname: Islam
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Mackie
mesh_terms: D000572:American Heart Association; D019072:Antibiotic Prophylaxis / Q000592:standards* / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D003756:Dental Hygienists / Q000523:psychology / Q000706:statistics & numerical data*; D004696:Endocarditis / Q000517:prevention & control*; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D019647:Oral Surgical Procedures / Q000009:adverse effects / Q000379:methods / Q000592:standards*; D010022:Osteopetrosis; D010820:Physicians / Q000523:psychology / Q000706:statistics & numerical data*; D017410:Practice Guidelines as Topic; D011795:Surveys and Questionnaires; D014481:United States
keywords: Endocarditis; dental hygienists; dentists; heart valve diseases; infective; practice guidelines; prophylaxis