manage the patient as if they were at normal risk of IE If antibiotic cover is needed, discuss with the patient about pros & cons of antibiotic prophylaxis to obtain informed consent about their management. Educate patient about the importance and relevance of good oral hygiene and infective endocarditis Significance of adequate oral hygiene Link between risk of IE & dental procedures or other invasive procedures Identify & have awareness of early signs/symptoms of infective endocarditis Know when to seek help/treatment when IE suspected Review any patients with significant risk of IE if they develop a dental infection, and manage without delay to minimize risk of IE development. Normal or no risk Dental treatment commenced without antibiotic cover. Patients need to be informed regarding their cardiac condition and infective endocarditis, and how this may affect dental treatment. Discussion of pros & cons of antibiotic prophylaxis, why it is not generally advocated Significance of adequate oral hygiene Link between risk of IE & dental procedures or other invasive procedures Identify & have awareness of early signs/symptoms of infective endocarditis Know when to seek help/treatment when IE suspected If patients are insistent on antibiotic prophylaxis, consult the patient's cardiologist before proceeding. Children with cardiac conditions Children with cardiac conditions have the same risks of IE as an adult patient. Difference in management lies with gaining consent where Gillick competence comes into play. A child may lack cooperation for dental procedures in which case, they may be considered to be referred for dental treatment under sedation or general anaesthetic. Emergency patients with cardiac conditions Check patient's cardiac condition and determine whether they belong in the selected body of patients who are at a more significant risk of IE. Consulting with a local cardiology centre or the patient's cardiologist may be appropriate. Manage infections without delay to minimise risk of IE development. Prescribing antibiotics It should be clear on the prescription that the antibiotics serve as prophylaxis Inform patients about the risks and possible side effects on prescribed drugs, how to seek help if side effects occur Inform patients on appropriate use of antibiotics (duration, time, route of administration) See also Infective endocarditis Preventive medicine Oral medicine References Dentistry