Are dental procedures an important risk factor for infective endocarditis? A case-crossover study

Although infective endocarditis (IE) is often reported to develop following dental treatment, no published data have accurately defined the risk of IE from dental procedures. The purpose of this study was to examine whether dental procedures constitute significant risk factors for endocarditis. The study population was composed of 170 hospitalized patients with infective endocarditis. The frequency of dental procedures during the 3-month period immediately before admission was compared with the frequency of such procedures during earlier 3-month control periods (when no endocarditis developed), using the case-crossover design. Thirty-four out of 98 patients with available information (35%) had had 81 dental procedures during the 2 years before hospitalization, 12 (12%) of whom had had 14 procedures during the 3 months before admission. The number and types of dental procedures performed during this 3-month period were not statistically different from those carried out during any earlier 3-month period, which served as a control period. Dental procedures do not significantly increase the risk of IE.