| Issue |
J Oral Med Oral Surg
Volume 30, Number 3, 2024
|
|
|---|---|---|
| Article Number | E4 | |
| Number of page(s) | 1 | |
| DOI | https://doi.org/10.1051/mbcb/2024028 | |
| Published online | 07 February 2025 | |
Editorial
Novel guidelines for the dental management of patients at risk of Infective Endocarditis in France
Claude Bernard University, Hospices Civils de Lyon, Lyon, France
* Correspondence: sarah.millot-guard@chu-lyon.fr
Received:
19
October
2024
Accepted:
23
October
2024
The great majority of French dental surgeons treat patients at high risk of endocarditis, even if this oral management is accompanied by legitimate apprehension, given the risks involved. There are numerous reasons for this complex approach: firstly, there are limited treatment options for patients at highest risk; secondly, the management of infectious and haemorrhagic risks; and thirdly, difficulties in identifying patients at high risk of endocarditis.
Recent data from the literature on the effectiveness of antibiotic prophylaxis and the importance of everyday bacteremia, as well as France's singular position in contraindicating certain oral procedures, pointed to the need for a change in French guidelines [1]. Since April 2024, the “Haute Autorité de Santé (HAS)” recommendations, endorsed by Dental and Medical scientific societies, have marked an evolution in the oral and dental management of patients at high risk of endocarditis [2]. We have finally left behind the “dogma of dental extractions” in patients who are already very fragile, and we can now offer a much wider range of treatments that must be part of a careful approach, including implantology, periodontal and pre-orthodontic surgery, endodontics and traumatology in pediatric dentistry.
The prevention of endocarditis is based on two components: the important general measures (oral health maintenance, among others) and preventive medication (with a change in the modality of prophylaxis). This recent text is part of an evolution initiated by the American and European Societies of Cardiology, and it will revolutionize our oral and dental management of these patients, aiming to improve their quality of life and facilitating their access to care: the management and prevention of this disease must be multidisciplinary, and odontologists have a role to play [3].
However, there are still questions to be raised, such as the extent to which practitioners and patients adhere to guidelines, and the identification of specific obstacles and facilitating factors for their dissemination.
References
- Thornhill MH, Gibson TB, Yoon F, Dayer MJ, Prendergast BD, Lockhart PB, et al. Endocarditis, invasive dental procedures, and antibiotic prophylaxis efficacy in US Medicaid patients. Oral Dis 2024;30:1591–1605. [Google Scholar]
- Prise en charge bucco-dentaire des patients à risque d'endocardite infectieuse − HAS, octobre 2024. [Google Scholar]
- Delgado V, Ajmone Marsan N, de Waha S, Bonaros N, Brida M, Burri H, et al. 2023 ESC Guidelines for the management of endocarditis. Eur Heart J 2023;44:3948–4042. [CrossRef] [PubMed] [Google Scholar]
Cite this article as: Millot S. 2024. Novel guidelines for the dental management of patients at risk of Infective Endocarditis in France. J Oral Med Oral Surg. 30, E4: https://doi.org/10.1051/mbcb/2024028
© The authors, 2025
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Current usage metrics show cumulative count of Article Views (full-text article views including HTML views, PDF and ePub downloads, according to the available data) and Abstracts Views on Vision4Press platform.
Data correspond to usage on the plateform after 2015. The current usage metrics is available 48-96 hours after online publication and is updated daily on week days.
Initial download of the metrics may take a while.