Preventing infective endocarditis

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Learn how to prevent infective endocarditis, a heart infection that can affect children with existing heart problems.

Key points

  • A child with an existing heart problem might get infective endocarditis while having an operation or dental treatment that causes bleeding.
  • If blood does not flow through your child’s heart or valves smoothly because of heart problems, your child is more likely to get infective endocarditis.
  • The chance of getting this infection is low, but it can possibly result in damage to the heart or death.
  • It is important to take good care of your child's teeth to avoid infection in the mouth.

This page explains the risks of infective endocarditis and why prevention is so important.

What is infective endocarditis?

Infective endocarditis (IE) is a serious infection of the heart caused by germs that get into the blood and stay in the heart. It was formerly known as bacterial endocarditis or subacute bacterial endocarditis (SBE).

A child with an existing heart problem might get infective endocarditis while having an operation or dental treatment that causes bleeding. Usually, a child’s body can kill the germs, and they do not get sick. But if blood does not flow through your child’s heart or valves smoothly because of heart problems, your child is more likely to get infective endocarditis. It is more likely to occur in children with complex cyanotic defects, shunts, and artificial heart valves.

The chance of getting this infection is low, but it can be very serious, possibly resulting in damage to the heart or death, if untreated.

It is much better to prevent infective endocarditis than to treat it. You can prevent your child getting infective endocarditis by taking these simple steps.

Tooth care

Take good care of your child’s teeth. These instructions will help you keep your child’s teeth healthy and avoid infection in the mouth.

  • Start early. Get your baby used to having a clean mouth. Wipe his gums gently with a damp face cloth after every feeding. This will help your baby get used to having his gums touched, and they will become less sensitive. You should start wiping their teeth as soon as your baby gets them. This starts when your baby is about 6 months old. Usually, you can use a toothbrush to clean your baby’s teeth when they are 1 year old.
  • Do not let your baby or child sleep with a bottle of milk or juice. A bottle of water is okay because it does not have sugar that can cause cavities. Breastfeeding or bottle-feeding on demand, which means when your baby wants it, can also cause cavities. You should clean your baby’s teeth after you breastfeed or bottle-feed your baby.
  • If your baby usually falls asleep right after the last breastfeeding or bottle-feeding, make sure you clean their teeth just before you give them this last feeding.
  • Do not use toothpaste to clean your child’s teeth until your child is 2 years old. A mineral in toothpaste called fluoride helps keep the teeth healthy, but too much fluoride may harm your child’s teeth. Your young child needs only a little fluoride. Use infant toothpaste with very little fluoride.
  • While your child is between 2 and 6 years old, they should use toothpaste only in very small amounts, or use a toothpaste with little fluoride.
  • Make sure your child brushes their teeth after every meal and snack. Your child should also brush their teeth after taking liquid medicine. Liquid medicine may have a lot of sugar that needs to be cleaned away.
  • Get your child to start flossing their teeth when their back teeth touch each other. Your child will need help flossing until they get used to doing it. Make sure your child flosses the teeth that touch each other. A toothbrush cannot clean between these teeth. During a visit to the dentist’s office, ask the dentist to show your child how to floss properly.
  • Take your child to the dentist for regular check-ups and make sure you tell the dentist about your child's heart condition.

Antibiotic prophylaxis

If your cardiologist has told you that your child requires infective endocarditis prophylaxis, make sure your child takes antibiotics before any dental treatment that may cause this infection. Your child's dentist will know which types of dental procedures require antibiotics.

Some children with heart problems may need to take antibiotics for the rest of their lives to prevent infective endocarditis. If you are not sure if your child needs antibiotics, ask your child’s doctor.

Medical alert bracelet

Your child may need a medical alert bracelet, which is a special bracelet that says what your child’s condition is. This bracelet helps a doctor know what special treatment your child may need when there is no one to speak for him. Ask your cardiologist if your child needs a medical alert bracelet.

More Information

Last updated: January 15th 2010