Prevention of endocarditis: communication between doctors and dentists

Area of Science:

• Cardiology
• Dentistry
• Public Health

Background:

• Guidelines for preventing infective endocarditis (IE) require dental practitioners to identify at-risk patients.
• Effective IE prophylaxis relies on dentists knowing which patients have predisposing cardiac conditions.
• Current communication channels between medical doctors and dentists may be insufficient for identifying at-risk patients.

Purpose of the Study:

• To assess dental practitioners' awareness of patients with cardiac disorders.
• To evaluate the effectiveness of current communication strategies in identifying patients needing IE prophylaxis.
• To identify barriers to implementing IE prophylaxis guidelines in dental practice.

Main Methods:

• A questionnaire was sent to patients with cardiac disorders and their dentists in the Grampian area.
• A survey was conducted among dentists regarding their records and knowledge of patients' cardiac conditions.
• Response rates were 53% for patients and 53/59 for dentists.

Main Results:

• Only 63 out of 145 at-risk patients reported seeing a dentist in the past two years.
• Nineteen dentists had no record of their patient's cardiac disorder.
• In only 17 cases was the cardiac information sufficient to warrant prophylaxis; communication was often patient-dependent, and 63% of dentists found doctor communication unsatisfactory.

Conclusions:

• There is a significant gap in dental practitioners' awareness of patients' cardiac conditions, hindering IE prophylaxis.
• Improved communication between doctors, patients, and dentists is crucial for implementing IE prevention guidelines.
• Direct communication from GPs/consultants to dentists and enhanced record-keeping (e.g., alert cards) are recommended.