Vulnerable dying after not getting antibiotics in dental visits, say doctors

Patients are dying needlessly every year due to vulnerable Britons with heart problems not being given antibiotics when they visit the dentist, doctors have said.

- Denis Campbell

Almost 400,000 people in the UK are at high risk of developing lifethreatening infective endocarditis any time they have dental treatment, the medics say. The condition kills 30% of sufferers within a year.

A refusal to approve antibiotic prophylaxis (AP) in such cases means that up to 261 people a year are getting the disease and up to 78 dying from it, they add. That policy may have caused up to 2,010 deaths over the last 16 years, it is claimed.

That danger has arisen because the National Institute for Health and Care Excellence (Nice) does not follow international good medical practice and tell dentists to give at-risk patients antibiotics before they have a tooth extracted, root canal treatment or even have scale removed, the experts claim.

The doctors who include a professor of dentistry, two leading cardiologists and a professor of infectious diseases - have outlined their concerns in the Lancet medical journal. In it, they urge Nice to rethink its approach in order to save lives, citing pivotal evidence that has emerged since the regulator last examined the issue in 2015, which shows that antibiotics are "safe, cost-effective and efficacious".

Infective endocarditis (IE) is an infection of the heart's inner lining and the valves that separate each of the heart's four chambers. In about 30%-40% of cases it is caused by bacteria in the mouth getting into the bloodstream as a result of poor oral hygiene or invasive dental treatment.

The bacteria can then inflame damaged heart valves and also artificial heart valves.