Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Apr 17;14(8):2784.
doi: 10.3390/jcm14082784.

Infectious Endocarditis Is Associated with Dental Treatment or Poor Dental Status-Results from the Brandenburg Endocarditis Registry (B.E.R.)

Roya Ostovar  1 , Anna-Maria Necaev  1 , Filip Schröter  1 , Farzaneh Seifi Zinab  2 , Gesine Dörr  3 , Gerhard Schmalz  4 , Johannes Maximillian Albes  1
Affiliations

Infectious Endocarditis Is Associated with Dental Treatment or Poor Dental Status-Results from the Brandenburg Endocarditis Registry (B.E.R.)

Roya Ostovar et al. J Clin Med. .

Abstract

Background: While the relationship between recent dental treatment and the development of endocarditis is largely undisputed, the relationship between poor dental status and the development of infective endocarditis has not yet been proven beyond doubt. We have therefore analyzed this hypothetical connection using our established endocarditis register (B.E.R.). Patients and Methods: A total of 72 patients who underwent dental treatment (TREAT) and 55 patients with a desolate dental status (DESOLATE) were found in our database of 530 patients subsequently developing infective endocarditis necessitating valve surgery. A propensity score analysis was performed comparing TREAT as well as DESOLATE with matched patients without these conditions as CONTROL. Results: TREAT showed significantly more often Strept. mitis (26.9%) as well as other Streptococci (36.54%, p = 0.001) compared to CONTROL (3.51% and 10.53%, respectively), whereas Staphylococci and E. faecalis were found more often in CONTROL than in TREAT (S. aureus: 22.81% vs. 15.38%, n.s.; other Staphylococci 14.04% vs. 1.92%, p = 0.033; E. faec.: 26.32% vs. 9.62%, p = 0.045). DESOLATE showed significantly more Strept. mitis compared to CONTROL (27.91% vs. 4.88%, p = 0.007). Early mortality was 23.7% in the TREAT group, while it was 15.25% in the CONTROL group and 17.02% in the DESOLATE group vs. 20.83% in the CONTROL patients. Conclusions: The current results suggest that adequate endocarditis prophylaxis to prevent bacteremia may not be carried out in patients undergoing dental treatment and may occur spontaneously in patients with poor dental care. Both situations require new strategies to avoid such severe consequences.

Keywords: Enterococcus faecalis; Staphylococcus areus; cardiac surgery; dental care; infectious endocarditis; oral hygiene; viridans Streptococci.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Figure 1 shows the distribution of bacteria in endocarditis patients in the CONTROL and TREAT groups after propensity score matching. Control: patients with endocarditis and normal oral and dental health without previous dental treatment; TREAT: patients with endocarditis and previous dental treatment; Staph. aureus: Staphylococcus aureus, Staph.: staphylococci; Str. mitis: Streptococcus mitis, E. faecalis: Enterococcus faecalis; Enterococc.: enterococci.
Figure 2
Figure 2
Figure 2 shows the distribution of bacteria in endocarditis patients in the CONTROL and DESOLATE groups after propensity score matching. CONTROL: patients with endocarditis and normal oral and dental health without previous dental treatment; DESOLATE: patients with endocarditis and a desolate dental status; Staph. aureus: Staphylococcus aureus; Staph.: staphylococci; Str. mitis: Streptococcus mitis; E. faecalis: Enterococcus faecalis; Enterococc.: enterococci.
See this image and copyright information in PMC

References

    1. Delgado V., Marsan N.A., de Waha S., Bonaros N., Brida M., Burri H., Caselli S., Doenst T., Ederhy S., Erba P.A., et al. 2023 ESC Guidelines for the management of endocarditis: Developed by the task force on the management of endocarditis of the European Society of Cardiology (ESC) Endorsed by the European Association for Cardio-Thoracic Surgery (EACTS) and the European Association of Nuclear Medicine (EANM) Eur. Heart J. 2023;44:3948–4042. doi: 10.1093/eurheartj/ehad193. - DOI - PubMed
    1. Ostovar R., Zinab F.S., Schröter F., Hartrumpf M., Fritzsche D., Albes J.M. Does Age Influence the Preoperative Condition and, Thus, the Outcome in Endocarditis Patients? J. Clin. Med. 2023;12:822. doi: 10.3390/jcm12030822. - DOI - PMC - PubMed
    1. Bergadà-Pijuan J., Frank M., Boroumand S., Hovaguimian F., Mestres C.A., Bauernschmitt R., Carrel T., Stadlinger B., Ruschitzka F., Zinkernagel A.S., et al. Antibiotic prophylaxis before dental procedures to prevent infective endocarditis: A systematic review. Infection. 2023;51:47–59. doi: 10.1007/s15010-022-01900-0. - DOI - PMC - PubMed
    1. Sperotto F., France K., Gobbo M., Bindakhil M., Pimolbutr K., Holmes H., Monteiro L., Graham L., Hong C.H.L., Sollecito T.P., et al. Antibiotic Prophylaxis and Infective Endocarditis Incidence Following Invasive Dental Procedures: A Systematic Review and Meta-Analysis. JAMA Cardiol. 2024;9:599–610. doi: 10.1001/jamacardio.2024.0873. - DOI - PMC - PubMed
    1. Thornhill M.H., Gibson T.B., Yoon F., Dayer M.J., Prendergast B.D., Lockhart P.B., O’Gara P.T., Baddour L.M. Antibiotic Prophylaxis Against Infective Endocarditis Before Invasive Dental Procedures. J. Am. Coll. Cardiol. 2022;80:1029–1041. doi: 10.1016/j.jacc.2022.06.030. - DOI - PubMed

LinkOut - more resources