Statement of intent
Statement of intent
This implementation advice has been developed primarily to assist dental teams to implement dentally relevant recommendations from NICE Clincal Guideline 64 (CG64) Prophylaxis against infective endocarditis.21 It aims to help dental teams to:
- identify those patients at high or moderate risk of IE, for whom antibiotic prophylaxis is recommended or should be considered
- provide information on prevention of IE to these patients
- identify which dental procedures require antibiotic cover
The implementation advice will also be of relevance to cardiac surgery and cardiology teams, pharmacists and other relevant healthcare professionals.
The evidence used by the NICE guideline committee has not been reassessed for this implementation advice. However, recent evidence which informs the classification of ‘at-risk’ dental procedures has been independently appraised. Relevant guidelines from the European Society of Cardiology (ESC) and the American Heart Association (AHA) have also informed the implementation advice. Other supplementary references cited in this document have been included to provide context and background information.
This implementation advice was first published in 2018 in response to an amendment to CG64. Changes to the ESC guideline in 2023, and an evidence surveillance review and further clarification to NICE CG64 in 2024, prompted a review of the 2018 implementation advice and this second edition was published in 2026. For more information on the history of this document see Methodology.
As with all SDCEP publications, the information presented here does not override the responsibility of the healthcare professional to make decisions appropriate to the individual patient, with their valid consent. It is advised that significant departures from this implementation advice, and the reasons for this, are documented in the patient’s clinical record.