Endocarditis prophylaxis is recommended for which patient populations undergoing dental procedures?

• A. Low-risk patients
• B. High-risk patients (prosthetic heart valves, prior history of endocarditis, certain congenital heart diseases)
• C. All patients
• D. Only those with congenital heart disease

Answer: (B)

Endocarditis prophylaxis during dental procedures is about protecting those who are most at risk for a serious outcome if bacteria enter the bloodstream. Dental work can cause transient bacteremia, and in people with certain heart conditions, this can lead to infective endocarditis on abnormal heart tissue. Therefore, prophylaxis is recommended for high-risk individuals—specifically those with prosthetic heart valves, a prior history of endocarditis, or certain congenital heart diseases. For low-risk patients, the potential harms of unnecessary antibiotics outweigh the small chance of benefit, so routine prophylaxis isn’t advised. It isn’t limited to congenital heart disease alone because other high-risk conditions, like prosthetic valves or previous endocarditis, also warrant protection.