If a patient with a heart condition is about to undergo a procedure and you have questions about the use of prophylactic antibiotics to prevent infective endocarditis (IE), you may refer to guidelines provided by the American Dental Association and the American Heart Association.

The American Heart Association published updated guidelines in Circulation in 2007, and subsequently worked with the ADA to produce a patient wallet card that provides information about dental procedures and prophylactic antibiotics. The wallet card states that: “Prophylaxis against IE is reasonable before dental procedures that involve manipulation of gingival tissue or the periapical region of teeth, or perforation of the oral mucosa.” The categories of patients covered by the recommendation are listed in the document.


The AAO recommends that members refer to the ADA/AHA guidelines and then contact the patient’s physician for confirmation of plans to administer, or not administer, prophylactic antibiotics. Once a decision is reached, all sources used for reference/consultation should be noted in the patient’s record.