Although the latest (1990) American Heart Association recommendations for the prevention of
bacterial endocarditis are by far the simplest yet, many physicians and dentists still do not comply with them. One of the reasons for this low compliance is that many clinicians rely on "myths" of dental-induced
endocarditis prevention. To educate clinicians on
endocarditis and its prevention, the myths of dental-induced
endocarditis prevention are analyzed. Myth 1: For the most part, physicians and dentists are aware of and comply with American Heart Association guidelines on
antibiotic prophylaxis for prevention of
infective endocarditis. Myth 2: Most cases of
bacterial endocarditis of oral origin are caused by dental procedures. Myth 3: American Heart Association
antibiotic regimens give almost total protection against
endocarditis after dental procedures. Myth 4:
Antibiotics should be administered for any dental procedure that causes
bleeding. Myth 5: If a patient was receiving recent
antibiotic therapy before the dental procedure, there is no need to change the dose or the
antibiotic before the dental procedure. Myth 6: The risk of
endocarditis is almost always greater than the risk of
antibiotic toxic effects. Myth 7: Parenteral
antibiotics before dental procedures are preferable for most patients with high-risk conditions (eg, prosthetic heart valves and previous history of
endocarditis). Myth 8: All patients with
mitral valve prolapse should routinely receive
antibiotic prophylaxis for dental procedures. Myth 9: Clinicians should err on the positive side of
antibiotic prophylaxis to prevent lawsuits.