Clinical Dental Community Health and Sociomedical Sciences, Division of Dental Community Health, College of Dental Medicine, Columbia University, New York, NY, USA.
Am J Orthod Dentofacial Orthop. 2012 Sep;142(3):348-54. doi: 10.1016/j.ajodo.2012.05.002.
For over 50 years, the American Heart Association has made recommendations for the prevention of infective endocarditis. The first guidelines were published in 1955; since then, they have been updated 9 times, most recently in 2007. There is still confusion about which orthodontic procedures are most prone to generate bacteremias and lead to infective endocarditis in susceptible patients. The aim of this study was to conduct a survey to determine orthodontists' knowledge, attitudes, and in-office behaviors regarding the American Heart Association's guidelines.
A 4-page online survey consisting of 3 sections was sent to members of the American Association of Orthodontists by using a random number generator. The first section consisted of demographic information, the second consisted of questions about the respondents' practice characteristics, and the third included questions about the respondents' knowledge and management of the treatment of patients at risk for infective endocarditis. There were 78 responses.
Orthodontists are screening for cardiac problems in the patient's medical history but to a lesser extent are requesting written medical clearance from the patient's physician before starting orthodontic treatment. Many of the orthodontists surveyed believed that their knowledge of the American Heart Association's guidelines and management of high-risk patients was in the good-to-excellent range. Orthodontists recommend antibiotic prophylaxis most frequently during band placement and removal. Patients at risk for infective endocarditis are somewhat likely to inquire about possible treatment sequelae associated with previous cardiac problems.
50 多年来，美国心脏协会一直针对感染性心内膜炎的预防提出建议。首份指南于 1955 年发布；此后，该指南已更新 9 次，最近一次更新是在 2007 年。对于哪些正畸操作最容易产生菌血症并导致易感患者发生感染性心内膜炎，仍存在混淆。本研究旨在进行一项调查，以确定正畸医师对美国心脏协会指南的了解、态度和临床行为。
采用随机数字生成器，向美国正畸医师协会的成员发送了一份包含 3 个部分的 4 页在线调查问卷。第一部分为人口统计学信息，第二部分为关于受访者实践特征的问题，第三部分包括关于受访者对处于感染性心内膜炎风险的患者的治疗的知识和管理的问题。共收到 78 份回复。
正畸医师在患者的病史中筛查心脏问题，但在开始正畸治疗前，较少要求患者的内科医生书面许可。许多接受调查的正畸医师认为，他们对美国心脏协会指南的了解和对高风险患者的管理处于良好至优秀的范围。正畸医师在结扎丝结扎和拆除时最常建议预防性使用抗生素。感染性心内膜炎风险患者可能会询问之前的心脏问题可能对治疗产生的后果。
