Any heart valve that is abnormal is susceptible to infection. This may
occur even when the abnormality is mild and is not otherwise causing any
trouble. Infection on the valve can be very serious causing a deterioration in
the function of the valve and even quite mildly abnormal valves can become
seriously leaky if treatment is not started quickly. Occasionally it may be
necessary to operate on a valve after it has become infected. Infection of
the valve invariably means a prolonged period in hospital. Whilst infection
can usually be treated, the best action is to avoid infection in the first place.
Micro-organisms in the mouth, particularly those around the teeth and gum,
will, during dental treatment, enter the blood stream. Normally these
micro-organisms will be quickly killed by the body’s own natural defences
but if the valves are abnormal the infection may settle on the valve before
the body’s own defences are effective. It is, therefore, of the utmost
importance that any patient with an abnormal valve should have antibiotics
to cover any dental procedure. Exact details will be provided by your
doctor. Other procedures, such as abdominal surgery, likely to lead to the
release of organisms into the blood stream, will also need to be covered by
antibiotics. Before valve surgery is undertaken, special attention is paid to the state
of the patient’s teeth and gums, and dental extractions may be advised.
Removal of all teeth (dental clearance) may be necessary to control
widespread infection in the mouth, but is not usually advised as a routine.
After valve replacement it is vital for a preventive (prophylactic) antibiotic
to be taken when visiting the dental surgeon. This is necessary for all dental
extractions, or any procedure which may cause bleeding from the gums. This
simple precaution can prevent the tragedy of an infection valve.