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Risk of Infective Endocarditis After Invasive Dental Procedures in Patients With Congenital Heart Disease.
Hsin-Mao Hsu1, Ya-Ting Chang1, Li-Wei Ou-Yang2
1Division of Pediatric Cardiology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan; School of Medicine, Chang Gung University College of Medicine, Taoyuan, Taiwan.
The Canadian Journal of Cardiology
|September 4, 2025
Summary
Invasive dental procedures increase infective endocarditis risk in congenital heart disease patients. The risk is highest in the first month after dental work and persists for up to three months.
Area of Science:
- Cardiology
- Infectious Diseases
- Dental Medicine
Background:
- Invasive dental procedures (IDPs) are a potential trigger for infective endocarditis (IE).
- Patients with congenital heart disease (CHD) are at higher risk for IE.
- Limited data exist on the precise risk quantification of IE following IDPs in CHD patients.
Purpose of the Study:
- To investigate the association between invasive dental procedures and the risk of infective endocarditis.
- To quantify the temporal risk of IE following IDPs in patients with congenital heart disease.
Main Methods:
- Nationwide, self-controlled case series study utilizing Taiwan's National Health Insurance Research Database (2009-2019).
- Analysis included 132,123 patients with CHD, focusing on 633 hospitalizations for IE.
- Conditional Poisson regression was used to estimate incidence rate ratios (IRRs) for IE within 0-4 months post-IDP.
Main Results:
- An increased overall risk of IE was observed following IDPs (adjusted IRR 2.27).
- The highest IE risk occurred in the first month post-IDP (IRR 3.03), with elevated risk persisting up to 3 months.
- This increased risk was consistent across various CHD severities, age groups, and comorbidities.
Conclusions:
- Invasive dental procedures are associated with a significantly increased risk of infective endocarditis in patients with congenital heart disease.
- The heightened risk of IE following dental procedures persists for up to three months, peaking in the first month.
- Findings underscore the need for heightened clinical vigilance and monitoring for IE in CHD patients undergoing invasive dental procedures.
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