What you need to know about Infective Endocarditis

Infective Endocarditis. This sounds like a frightening disease, and it definitely is. In fact, it can kill you. Fortunately, one of the most common causes is easily prevented. How can you protect yourself from this deadly disease? By simply keeping your mouth healthy!


What is Infective Endocarditis? It is an infection of the endocardium, which is the membrane that lines the inside of the heart, protecting it. As you can imagine, an infection on the tissue that is supposed to protect your heart will quickly become life-threatening.



There are two types of infective endocarditis, acute and subacute. Acute IE develops quickly and becomes life-threatening in days if left untreated. Symptoms of acute IE are a high fever, fatigue, and a rapid heart rate. It will also cause extensive damage to heart valves.


Subacute IE develops more slowly, over weeks and even months, but it is also fatal if not treated. It will usually cause a mild fever, fatigue, a moderately fast heart rate, sweating or night sweats, and low red blood cell count. Both types of infective endocarditis cause chills, joint pain, paleness, and tiny, reddish, freckle-sized spots in the whites of the eyes or on the skin. They can also cause heart murmurs.


Normally, your heart is highly resistant to infection. This is partly because the endocardium protects it, and partly because the constant blood flow keeps bacteria and fungi from settling on the structures of the heart. Unfortunately, some people are more susceptible to infection, usually because they have certain heart defects or diseases. The people most vulnerable to infective endocarditis are those who have a prosthetic heart valve, pacemaker or defibrillator, or have a weakened immune system. Another major risk is injecting illegal drugs because dirty needles are more likely to inject the harmful bacteria directly into the bloodstream. Other risk factors include birth defects of the heart, heart valve damage from rheumatic fever, and degeneration of the heart valves.


In rare instances, when there are massive amounts of bacteria in the bloodstream, healthy people with no risk factors can develop infective endocarditis. Normally, your body is perfectly capable of destroying bacteria that don’t belong in the bloodstream. Unfortunately, when there are huge amounts of the bacteria, your body’s defense systems are unable to keep up and the bacteria will adhere to a surface where they do not belong, then colonize and cause infection.


What bacteria are most likely to cause infective endocarditis, and how can they build up to harmful quantities? Viridans streptococci bacteria are the cause of approximately half of all cases of infective endocarditis in the United States. This particular type of bacteria is also the cause of tooth decay, or cavities, for most people. If you have a large number of them in your mouth, they are more likely to enter your bloodstream and cause problems elsewhere in your body.


A recent study found definitive proof that poor oral hygiene and dental disease are important risk factors for bacteria in the bloodstream, called bacteremia, and infective endocarditis. The researchers determined that if you have gingivitis or tooth decay, bacteria more easily enter your bloodstream when you have a dental procedure. Unfortunately, the bacteria also enter your bloodstream any time you make your gums bleed, such as when brushing or flossing your teeth. The good news is that the study also stated, “We now have scientific evidence that good oral hygiene and gingival health are associated with a reduced risk of developing bacteremia, which may translate into a reduced risk of developing IE.” This means that if you keep your teeth and gums healthy your gums are less likely to bleed from daily activities. When they do bleed, you also greatly reduce your risk of getting this life-threatening disease because you have fewer of the harmful bacteria in your mouth to enter your bloodstream. With smaller numbers of bacteria in your bloodstream, your immune system can more easily do its job to neutralize them before they cause harm.


It may sound strange that you can get a life-threatening disease from poor oral health. Is this a unique situation, or are there other ways your health can be harmed from it? There are actually many other health conditions that have been linked to poor oral health. A few examples are respiratory infections, diabetes, cardiovascular disease, dementia, some types of cancer, infertility, and pregnancy complications. This shows that your oral health is highly connected to the health of the rest of your body.


How Can You Minimize the Risk?


If you do have health problems that cause you to have a higher risk of developing infective endocarditis, your dentist can help you reduce your risk of developing it after a dental procedure. Antibiotic prophylaxis, a single dose of antibiotics taken one hour before a dental procedure, will help your body fight the harmful bacteria. The American Dental Association recommends antibiotic prophylaxis for anyone in a high-risk group.


The most important thing you can do to lower your risk of developing infective endocarditis, or any other disease linked to poor oral health, is to take excellent care of your mouth! Brushing twice a day with fluoride toothpaste and flossing every day is mandatory for good oral hygiene. Replace your toothbrush as soon as the bristles begin to fray, at least every four months. Frayed toothbrushes do not clean as thoroughly, allowing bacteria to remain on your teeth.


Visit your dentist for regular cleanings. Not only does this keep your mouth healthier, it also allows your dentist to catch problems while they are still small. If you let gum disease or tooth decay worsen, it gives greater numbers of harmful strains of bacteria the opportunity to colonize in your mouth, increasing your risk for disease. It is also important to contact your dentist as soon as you notice an oral health issue.


Finally, to keep your mouth in optimal health, avoid tobacco, eat a healthy diet and avoid snacking. The best diet for your oral health is one that consists mostly of veggies, fruit, dairy, lean proteins, and nuts. Don’t forget to drink plenty of water.


If you have children, it is important to teach them how to keep their mouth healthy. Did you know that you are supposed to brush your child’s teeth until they are six or seven years old? Unfortunately, many parents have never heard that. At Jungle Roots Children’s Dentistry and Orthodontics, we believe that a well-informed family is an important factor in preventing dental disease, so Dr. Culp spends a lot of time educating kids and their parents on proper dental hygiene. We have also compiled a guide to help you teach your child good oral hygiene habits, to set them up for a life of excellent oral health. Establishing a dental home at an early age is the key to a lifetime of positive visits to the dentist, so we have created a fun-filled, jungle themed environment with a caring team so your child can feel safe and comfortable during their time in our office.


Since the health of your mouth has such an enormous impact on your entire body, it is vital to keep it in excellent health. Next time you are tempted to skip brushing your teeth after your midnight snack, or put off a routine cleaning, remember that you are risking more than just getting a cavity!



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At Jungle Roots Children’s Dentistry & Orthodontics, we strive to provide the highest comprehensive pediatric and orthodontic dental care in a unique, fun-filled environment staffed by a team of caring, energetic professionals. We believe the establishment of a “dental home” at an early age is the key to a lifetime of positive visits to the dentist.


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