Risk of bacterial endocarditis?!
Question:
Risk of bacterial endocarditis?
My brother was born with aortic stenosis and a bicuspid aortic valve that was surgically corrected 2 years ago using the Ross Procedure (removing the diseased aortic valve and replacing it with his pulmonary valve then getting a donor pulmonary valve). He has to go in next week to get two small cavities filled and the dentist prescribed him amoxicillin to take beforehand to reduce the risk of bacterial endocarditis.
He has been joking that he won't take the pills and will see what will happen. What's the risk of actually getting bacterial endocarditis if he doesn't take the pills?
Answers:
The ADA guidelines regarding bacterial endocarditis recently changed, and I'm unsure that he actually needs to be premedicated prior to dental work. He would require premedication under the old guidelines. He may want to inform his dentist that the guidelines have recently changed (they are much more relaxed) as some dentists are unaware of this recent change. The guidelines also call for 2 g amox 1 hr prior to dental work.
The risk of developing it is very low, particularly with nonsurgical dental procedures, but the consequences are very serious if he gets bacterial endocarditis.