Keywords
Prophylactic antibiotics
Knowledge
Cardiac conditions
Dental procedures
Categories
How to Cite
Abstract
Background: The involvement of oral bacterias in the occurrence of infective endocarditis (IE) has prompted the adoption of antibiotic prophylaxis prior to dental procedures for patients at high risk. This paper aimed to assess the knowledge of Moroccan dentists regarding the management of patients with heart disease at risk of infective endocarditis.
Methods: This was a cross-sectional descriptive-analytical study that targeted 200 dentists in Rabat, Morocco. A questionnaire with 16 questions was distributed randomly. The level of dentists' level of knowledge was established based on the number of correct answers for each section and responses were assessed according to the American Heart Association (AHA) 2007 guidelines.
Results: Only 133 practitioners have agreed to participate in our study with a response rate of 66,5%. 87% of dentists reported contacting the cardiologist before starting treatment, 33% of practitioners weren’t aware of any guidelines and 20% knew AHA 2007, 52% reported not following guidelines in the management of patients with heart disease. Among the cardiac conditions and dental procedures proposed in the questionnaire which required prophylaxis; 8% and 2% respectively chose the correct answer according to the AHA’s 2007 guidelines. 31% of dentists answered correctly on the prescription of antibiotic prophylaxis protocol according to the latest recommendations.
Conclusion: According to our results, the knowledge of Moroccan private general dentists towards endocarditis prophylaxis was at a low level. The study highlights the need for continuous education.
References
Thuny F, Grisoli D, Cautela J, Riberi A, Raoult D, Habib G. Infective Endocarditis: Prevention, Diagnosis, and Management. Can J Cardiol. 2014 Sep; 30(9):1046-57. https://doi.org/10.1016/j.cjca.2014.03.042
Prendergast B D. The changing face of infective endocarditis. Heart. 2006 Jul; 92(7): 879-85. https://doi.org/10.1136/hrt.2005.067256
Wilson W, Kathryn A, Taubert and al. Prevention of Infective Endocarditis: Guidelines from the American Heart Association. Circulation. 2007 Apr; 116:1736-1754.https://doi.org/10.1161/CIRCULATIONAHA.106.183095
Habib G, Hoen B, Tornos P, Thuny F, Prendergast B, Vilacosta I, et al. Guidelines on the prevention, diagnosis, and treatment of infective endocarditis (new version 2009): the Task Force on the Prevention, Diagnosis, and Treatment of Infective Endocarditis of the European Society of Cardiology (ESC). Endorsed by the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) and the International Society of Chemotherapy (ISC) for Infection and Cancer. Eur Heart J. 2009 Oct;30(19) :2369-413. https://doi.org/10.1093/eurheartj/ehp285
Duval X, Delahaye F, Alla F, Tattevin P, Obadia JF, Le Moing V, et al. Temporal trends in infective endocarditis in the context of prophylaxis guideline modifications: three successive population- based surveys. J Am Coll Cardiol. 2012 May 29; 59(22):1968-76. https://doi.org/10.1016/j.jacc.2012.02.029
Moreillon P, Que YA. Infective endocarditis. Lancet 2004 Jan 10; 363(9403):139-49. https://doi.org/10.1016/s0140-6736(03)15266-x
Duval X, Leport C. Prophylaxis of infective endocarditis: current tendencies, continuing controversies. Lancet Infect Dis. 2008 Apr;8(4):225-32. https://doi.org/10.1016/s1473-3099(08)70064-1
Bannay A, Hoen B, Duval X, Obadia JF, Selton-Suty C, Le Moing V, et al. The impact of valve surgery on short- and long-term mortality in left-sided infective endocarditis: do differences in methodological approaches explain previous conflicting results? Eur Heart J. 2011Aug;32(16):2003-15. https://doi.org/10.1093/eurheartj/ehp008
Charles H, Rammelkamp, Committee On Prevention of Rheumatic Fever and Bacterial Endocardis. Prevention of rheumatic fever and bacterial endocarditis through control of streptococcal infections. Circulation. 1955;15(1):154-158. https://doi.org/10.1161/01.CIR.15.1.154
Delahaye F, Harbaoui B, Cart-Regal V, Gevigney G. Recommendations on prophylaxis for infective endocarditis: Dramatic changes over the past seven years. Arch Cardiovasc Dis. 2009 Mar; 102(3): 233-245. https://doi.org/10.1016/j.acvd.2009.01.002
Coutinho AC, Castro GF, Maia LC. Knowledge and practices of dentists in preventing infective endocarditis in children. Spec Care Dentist. Jul-Aug 2009; 29(4): 175-8. https://doi.org/10.1111/j.1754-4505.2009.00087.x
Zadik Y, Findler M, Livne S, Levin L, Elad S. Dentists' knowledge and implementation of the 2007 American Heart Association guidelines for prevention of infective endocarditis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008 Dec; 106(6): e16-9. https://doi.org/10.1016/j.tripleo.2008.08.009
Oliver R, Roberts GJ, Hooper L, Worthington HV. Antibiotics for the prophylaxis of bacterial endocarditis in dentistry. Cochrane Database Syst Rev. 2008 Oct; 8(4): CD003813. https://doi.org/10.1002/14651858.cd003813.pub3
Gopalakrishnan PP, Shukla SK, Tak T. Infective endocarditis: rationale for revised guidelines for antibiotic prophylaxis. Clin Med Res. 2009 Sep; 7(3): 63-8. https://doi.org/10.3121/cmr.2009.848
Chate RA. An infective endocarditis audit illustrates why dental guidelines in general need to be kept clear, simple and unambiguous. Br Dent J. 2008 Sep 27; 205(6): 331-5. https://doi.org/10.1038/sj.bdj.2008.805
Nakano K, Ooshima T. Common knowledge regarding prevention of infective endocarditis among general dentists in Japan. J Cardiol. 2011 Jan; 57(1): 123-30. https://doi.org/10.1016/j.jjcc.2010.09.001
Bhayat A, Jarab F, Mansuri. S and al. Assessment of Knowledge of Dental Staff at a Saudi Arabian University Regarding the Prophylaxis for Infective Endocarditis. Open Dent J. 2013 Jul 26; 7:82-7. https://doi.org/10.2174/1874210601307010082
Eskandari A, Abolfazli N, Lafzi A. Endocarditis Prophylaxis in Cardiac Patients: Knowledge among General Dental Practitioners in Tabriz. J Dent Res Dent Clin Dent Prospects. 2008;2(1):15-9. https://doi.org/10.5681/joddd.2008.003
Chitsazi MT, Pourabbas R. Knowledge of dentists who practice in Tabriz regarding the latest prophylaxis regimens for prevention of infective endocarditis. Med J Tabriz Uni Med Sci. 2004; 64(38):40-44. [Accessed 29 Jun 2021]. Available From: https://www.sid.ir/en/journal/ViewPaper.aspx?ID=27802
Boyle N, Callagher C, Sleaman D. Antibiotic prophylaxis for bacterial endocarditis: a study of knowledge and application of guidelines among dentists and cardiologists. J Ir Dent Assoc. 2006; 51(5):232-7.
Cloitre A, Duval X, Lesclous P. Antibiotic prophylaxis of infective endocarditis, compliance with recommendations of good practice, national survey of dental surgeons. Med Buccale Chir Buccale. 2014; 20(3):141-153. https://doi.org/10.1051/mbcb/2014019
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2018 Hajar Ben Mohimd et al.
