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Good dental health is crucial for individuals living with childhood-onset heart disease (CoHD) as it plays a vital role in reducing the risk of serious conditions such as infective endocarditis. This factsheet provides important information about infective endocarditis, its symptoms, causes, and prevention, empowering you to take proactive steps toward protecting you or your child’s heart health.

HeartKids support staff can help you navigate your journey as you care for your child, and connect with you critical support resources. 

You can contact our helpline on 1800 432 785 for tailored, empathetic advice.

What is infective endocarditis?

Infective endocarditis is a rare but serious infection that occurs when bacteria enter the bloodstream and attach to rough patches in the heart. Dental issues like tooth decay and gum disease are common sources of these bacteria, making proper oral care and regular dental check-ups an important part of preventing this condition.

Your risk of developing infective endocarditis is increased if you:

• have had a valve replacement
• were born with a heart condition other than an isolated atrial septal defect, a repaired ventricular septal defect or a repaired patent ductus areteriosus
• have hypertrophic cardiomyopathy
• have a disease affecting your heart valves
• have had infective endocarditis before

What causes infective endocarditis?

Infective endocarditis is caused by certain types of bacteria that get into the blood stream in very large numbers.

Small numbers of bacteria in the blood are usually quickly destroyed by the body’s immune system. However, when a large number of bacteria rush into the blood (bacteraemia), they will form strings which can then stick to rough patches of the heart.

Infective endocarditis can only develop if there is a rough patch in the heart for the bacteraemia to attach to. This means that if you have a heart condition, the risk of you becoming infected depends on whether your condition has caused rough patches on what should otherwise be a smooth surface in the heart.

Rough patches are likely to occur where the blood is turbulent. For example, blood passing through a VSD at high pressure, could cause roughening to the lining of the valves in the right ventricle.

Rough patches can also occur if there are areas of scarring in the heart, usually from surgery. Once the bacteraemia attach to
a rough patch in the heart, an infection develops and infective endocarditis can then spread within the heart

Symptoms of infective endocarditis

The symptoms of infective endocarditis can either develop slowly or come on suddenly. These can include:

• Flu-like symptoms, fever and chills
• Fatigue
• Aching joints and muscles
• Night sweats
• Shortness of breath and/or chest pain when you breathe
• Small pin-point purplish rash on fingertips and/or toes
• Swollen abdomen
• A new or changed heart murmur

Preventing infective endocarditis

There are a few things that you can do to try and prevent getting infective endocarditis.

Dental problems such as tooth decay and gum disease can lead to infective endocarditis – so it’s important to make sure that your teeth and gums are properly looked after.

Avoid any body piercing or tattooing as these carry a high risk of infection. Piercings on or around the mouth are especially risky.

You should check with your cardiologist if ear piercing should be carried out with antibiotic cover.

Good oral health habits

Reduce your risk of developing infective endocarditis by building good oral health habits. That means:

• Brush your teeth two times a day
• Use a toothbrush and fluoride toothpaste
• Clean between your teeth using floss, an interdental toothbrush or a water flosser
• Have regular check-ups (twice yearly) with your dentist

In addition, consult your cardiologist before any dental procedures.

How HeartKids Can Help

The HeartKids support team can offer both emotional and practical support, including referrals to mental health and wellbeing services.

HeartKids Helpline

Available 9am–5pm AEST, Mon–Fri

Call: 1800 432 785
Webchat: heartkids.org.au

Mental Health Counselling Service

HeartKids offers a confidential mental health counselling service – call the HeartKids Helpline on 1800 432 785 to obtain a referral.

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