Infective endocarditis and dentistry: the legal basis for an association.

Abstract:

OBJECTIVES:The objectives of this study were to determine on what evidence infective endocarditis (IE) could be legally linked to dental treatment. METHOD:The records of 319 legal cases involving dental treatment as the probable cause of IE were analysed. The medical history, type of dental operation, and whether antibiotic prophylaxis was provided were noted. The time taken for the onset of symptoms (incubation period) and hospitalisation was calculated. The identity of the infecting micro-organism was investigated and it was also noted whether litigation was successful for the patient. RESULTS:A total of 83 patients were successful in legally linking dental treatment to the onset of infective endocarditis. In all successful cases there was a short incubation period (circa nine days) and in 80 of the patients an oral Streptococcus was isolated. The dental operations included exodontia (28), scaling (29), endodontics (12) and minor oral surgery (11). CONCLUSIONS:Dental treatment was deemed to be the probable cause of IE in 26% of patients who sought litigation. In the majority of legal cases clinicians did not follow recognised guidelines or keep adequate clinical notes. The three main factors which link dental procedures legally were the dental operation, the isolation from the blood of an oral micro-organism and a short incubation period.

journal_name

Br Dent J

journal_title

British dental journal

authors

Martin MV,Longman LP,Forde MP,Butterworth ML

doi

10.1038/bdj.2007.123

subject

Has Abstract

pub_date

2007-07-14 00:00:00

pages

E1; discussion 38-9

issue

1

eissn

0007-0610

issn

1476-5373

pii

bdj.2007.123

journal_volume

203

pub_type

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