Introduction
Endocarditis is an illness where infection develops on the heart valves or other heart tissues. This infection is extremely difficult to treat. It usually requires a long hospital stay and being treated with antibiotics given into a vein. Patients who develop endocarditis can be extremely unwell and often require heart surgery to remove the infected area. Sometimes people die from endocarditis.
What are the symptoms of endocarditis?
Patients with endocarditis develop a temperature and feel unwell, often with symptoms like flu, such as:
- High temperature
- Shivering or chills
- Fatigue
- Night sweats
- Loss of appetite and weight loss
- Muscle, joint or back pain that is unrelated to recent physical activity
Flu is very common and usually resolves after about 7-10 days. Symptoms which persist for longer than this should be reported to your GP as well as your heart team.
Dental health
The most common source of the bacteria that cause endocarditis is the mouth. Everyone’s mouth carries bacteria but if your teeth and gums are in poor condition the risk of developing endocarditis is increased. Good oral health is therefore particularly important to reduce the risk of endocarditis.
You can help reduce the risk of endocarditis by:
Brushing your teeth
- Tooth brushing twice a day, using a fluoride toothpaste, with supervision from an adult until the age of at least 7-8 years old.
Eating healthy
- Having a healthy diet, avoiding sugary snacks and drinks. Drink plain water/milk between meals.
Dental check-ups
- Visiting your dentist for regular check-ups.
Seek treatment
- If your child has toothache or infection in their mouth, dental care should be sought as soon as possible.
Additional useful information can be found by accessing the links below:
British society of paediatric dentistry Tooth Brushing Habit A practical guide to children’s teeth (pdf) Dental care for children with CHD (pdf) Katie Bear goes to the dentist (pdf)Should antibiotics be given before dental care in children and young people at risk of infective endocarditis?
Recent national guidance has changed. Antibiotics are not routinely recommended for everyone, but they may now be offered or considered for some children at high risk of infective endocarditis when they are having certain dental procedures.
At the Yorkshire and Humber Congenital Heart Disease Service, we follow this updated guidance. Your child’s Paediatric Cardiologist, Paediatrician with Expertise in Cardiology, or Specialist Nurse will advise you whether your child is at high risk of infective endocarditis, and whether antibiotics may be needed before dental treatment.
For many children, including those at moderate risk, antibiotics are still not recommended.
Keeping your child’s teeth and gums healthy with good oral hygiene and regular dental visits remains the most important way to reduce the risk of infective endocarditis. Your cardiology team will continue to provide advice and support about this at clinic appointments.
What if I am having difficulties finding a dentist?
- Visit the NHS website which keeps a directory of local dental services www.nhs.uk
- Call NHS 111 who can provide advice and/or provide access to emergency dental services.
Body art: tattoos and piercings
Any procedures that break the skin such as tattooing, body piercing and cosmetic treatments, including eyebrow microblading, Botox and dermal fillers can introduce bacteria into the blood stream and could cause endocarditis.
Whilst we will always advise against these procedures, if you do choose to proceed, the following points will help you to make the procedure as safe as possible:
- Follow the cleaning guidelines from the practitioner until the wound is fully healed. Good hygiene is vital.
- If a piercing/tattoo becomes red and sore, you should remove the piercing and seek medical attention. Antibiotics to treat the local infection may be required.
- If you need to remove a piercing because of infection, you should not replace it until the infection is completely cleared and seriously consider whether you should leave it out altogether
Further information
If you have any questions or concerns please speak to the
