Measuring Differences of Interpretation among Dentists on Antibiotic Prophylaxis Guidelines

Aim: To determine if the 2007 American Heart Association guidelines for dentists' prescription of prophylactic antibiotics guarding against bacterial endocarditis, which are based on gingival manipulation, are applied consistently by dental faculty. Methods: An emailed survey was conducted of U.S. and Canadian dental faculty regarding which of 24 dental procedures require gingival manipulation and which require prophylactic antibiotics. Confidence intervals were calculated for the proportion of subjects who considered gingival manipulation part of a procedure. If the confidence interval included 75%, we deemed it a consensus. Similarly, we calculated confidence intervals for whether subjects would prescribe antibiotics, and deemed 75% to be a consensus. Results: 122 subjects responded to the survey. No response rate could be calculated. Faculty reached consensus on prescribing for 66% of procedures. For gingival manipulation, consensus was achieved for 83% of the procedures. Conclusion: The lack of concordance between the two categories suggests that the 2007 guidelines are unclear for the dental faculty members. This conclusion likely extends to all dentists.