06-06-2009, 02:09 AM
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mcq - nimishkum
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06-06-2009, 02:16 AM
Hi zibil,
article says: Although it has long been assumed that dental procedures may cause IE in patients with underlying cardiac risk factors and that antibiotic prophylaxis is effective, scientific proof is lacking to support these assumptions. The collective published evidence suggests that of the total number of cases of IE that occur annually, it is likely that an exceedingly small number are caused by bacteremia-producing dental procedures. Accordingly, only an extremely small number of cases of IE might be prevented by antibiotic prophylaxis even if it were 100% effective. The vast majority of cases of IE caused by oral microflora most likely result from random bacteremias caused by routine daily activities, such as chewing food, tooth brushing, flossing, use of toothpicks, use of water irrigation devices, and other activities. The presence of dental disease may increase the risk of bacteremia associated with these routine activities. There should be a shift in emphasis away from a focus on a dental procedure and antibiotic prophylaxis toward a greater emphasis on improved access to dental care and oral health in patients with underlying cardiac conditions associated with the highest risk of adverse outcome from IE and those conditions that predispose to the acquisition of IE. But still it is controversial uptodate says: risk of IE is generally considered to be the highest for all dental procedures that involve manipulation of either gingival tissue or the periapical region of teeth or perforation of the oral mucosa, so prophylaxis can b given in them |
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