Infective Endocarditis – Where Cardiology Meets Dentistry

Abstract

Background. Infective endocarditis (IE) remains a serious cardiovascular infection associated with substantial morbidity and mortality. The oral cavity is an important microbial reservoir, and oral microorganisms, particularly viridans group streptococci, may contribute to IE development. However, the relationship between oral health, dental procedures, bacteremia, and IE remains complex.

Aim. To synthesise current knowledge on the interaction between dentistry and cardiology in the prevention and management of IE, with emphasis on oral health, dental procedure-associated bacteremia, antibiotic prophylaxis, and interdisciplinary care.

Material and methods. A narrative review of current international guidelines and published literature was performed, including the 2023 European Society of Cardiology Guidelines, the 2021 American Heart Association scientific statement on prevention of viridans group streptococcal IE, and relevant clinical and microbiological studies.

Results. Invasive dental procedures may cause transient bacteremia; however, cumulative bacterial exposure during daily oral activities may be substantial, particularly in individuals with poor oral hygiene and periodontal inflammation. Current guidelines recommend antibiotic prophylaxis only for patients at the highest risk of severe IE undergoing selected invasive dental procedures. Optimal oral hygiene, regular dental care, and treatment of active oral infections remain essential preventive measures. Effective communication between cardiologists, cardiac surgeons, and dental professionals is an important component of comprehensive IE prevention.

Conclusions. Prevention of IE requires an individualized, risk-based approach integrating cardiovascular risk assessment with appropriate dental management. Maintaining oral health and strengthening multidisciplinary cooperation are key elements of effective preventive care.