Tuesday, November 18, 2008

Dentists' knowledge and implementation of the 2007 American Heart Association guidelines

Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008 Dec;106(6):e16-9.

Dentists' knowledge and implementation of the 2007 American Heart Association guidelines for prevention of infective endocarditis.

Zadik Y, Findler M, Livne S, Levin L, Elad S; American Heart Association.

Department of Oral Medicine, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel. yzadik@gmail.com

OBJECTIVES: Our aim was to evaluate the knowledge and implementations of the 2007 American Heart Association guidelines for the prevention of infective endocarditis (IE) among practicing Israeli dentists, 12 months after their publication. STUDY DESIGN: A total of 118 dentists completed a questionnaire regarding required antibiotic prophylaxis for 10 specific cardiac patient subtypes before invasive dental treatment, prophylactic need in at-risk patients for IE in 10 dental procedures, and prophylactic regimen for nonallergic patients. RESULTS: Correct answer response for cardiac conditions was 81.3% (highest failure: mitral valve prolapse [MVP] with regurgitation). There was a consensus among the participants regarding antibiotic regimen for high-risk patients during several dental procedures, such as intraoral radiography, tooth extraction, and periodontal surgery, but a controversy for other procedures. The procedures of disagreement were endodontic treatment, tooth preparation with oral impressions, and restoration of class II caries lesion. Correct antimicrobial agent, dose, and timing were prescribed by 99%, 93.8%, and 100% of the respondents, respectively. CONCLUSIONS: Relatively high level of knowledge of the new guidelines was found among dentists, reflecting both familiarity of the practitioners with the guidelines and acceptance of guidelines. Prophylactic need is ambiguous during restorative, endodontic and prosthetic procedures. Educational resources should emphasize these guidelines, specifically the reduced risk level for MVP with regurgitation patients.

No comments: