Review Article|Articles in Press

World Workshop on Oral Medicine (WWOM) VIII: Dentists´ compliance with infective endocarditis prophylaxis guidelines for patients with high-risk cardiac conditions: A systematic review

Published:March 03, 2023DOI:



      To determine dentists' awareness/adherence to antibiotic prophylaxis (AP) guidelines for the prevention of infective endocarditis (IE) in patients with high-risk heart conditions.

      Study Design

      A systematic literature review was performed on MEDLINE/PubMed, Scopus, Web of Science, Cochrane Library, Proquest, Embase, Dentistry and Oral Sciences Source databases, following the PRISMA checklist. Nationwide studies based on questionnaires, surveys, and interviews completed by dentists and published since 2007 were included.


      From 2907 articles screened, 28 studies were selected (across 20 countries). The quality of included studies was poor due to lack of standard evaluation tools, low response rates, and lack of questionnaire validity/reliability. Approximately 75% of surveyed dentists reported being knowledgeable about AP guidelines, but only ∼25% complied with them. Reported compliance with American Heart Association (AHA) guidelines was fourtimes higher than with the National Institute for Health and Care Excellence (NICE) recommendations. Some of the highest adherence rates were reported for other national AP guidelines. Significant geographical differences were observed in the estimated adherence to AHA guidelines and the percentage of dentists who reported seeking advice from physicians/cardiologists.


      Rates of compliance/adherence were substantially different from rates of knowledge/awareness, including relevant geographical dissimilarities. Compliance/adherence was higher for AHA than NICE.
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