Assessing Variances in Dentist's Interpretations of Antibiotic Prophylaxis Guidelines: A Survey of Dental School Faculty.

Abstract

Purpose: A recent review by the American Heart Association (AHA) noted a decrease in the prescription of antibiotic prophylaxis (AP) for infective endocarditis (IE) following the release of their guidelines in 2007. However, studies indicate dentists may still face challenges in identifying which procedures require AP and which procedures are considered to involve gingival manipulation (GM) requiring the need for AP. Methods: A sample of dental school faculty was surveyed to assess their likelihood of prescribing AP for various dental procedures when treating individuals at high risk for IE and their perception of the likelihood of those procedures involving GM. Results: A total of 134 individuals responded to the survey. Consensus on AP was not achieved for eight of 24 procedures, and consensus on GM was not achieved for four out of 24 procedures. Conclusions: Data gathered revealed a difference of opinions among dental faculty concerning the appropriate dental procedures warranting the prescription of AP for patients at risk of IE. Similarly, there was a lack of consensus among dental faculty regarding dental procedures specifically involving GM. The discordance observed between these two categories implies a potential lack of clarity in the 2007 AHA guidelines. The criteria related to GM for determining the necessity of AP in high-risk individuals may introduce confusion for dental faculty, possibly extending to dentists practicing in nonacademic settings. Such ambiguity can potentially contribute to inappropriate decision-making regarding the prescription of AP.