{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:50:01Z","timestamp":1791420601711,"version":"4.3.3"},"reference-count":39,"publisher":"PAGEPress Publications","issue":"3","license":[{"start":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T00:00:00Z","timestamp":1748304000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Monaldi Arch Chest Dis"],"abstract":"<jats:p>Infective endocarditis (IE) remains a life-threatening condition associated with high morbidity and mortality, often influenced by the complex interplay between systemic and oral health. The increasing recognition of oral health as a risk modifier has led to greater focus on the oral microbiome, dental procedures, and periodontal disease as potential contributors to bacteremia and IE. This review critically examines the relationship between oral health and IE, exploring pathophysiological mechanisms, risk factors, and the evolving epidemiology of the disease. The discussion includes diagnostic challenges, particularly in culture-negative cases, and the emerging role of advanced imaging and molecular diagnostics in improving early detection. A central focus is placed on preventive strategies, highlighting the debate surrounding antibiotic prophylaxis (AP) in high-risk individuals and the potential role of periodontal therapy in reducing systemic inflammation and transient bacteremia. The review also addresses the growing concern of antimicrobial resistance and the necessity of balancing AP recommendations with antimicrobial stewardship. Additionally, this review identifies critical research gaps, including the need for longitudinal studies on the impact of oral health interventions on IE incidence and the importance of interdisciplinary collaboration between dental and medical professionals in optimizing patient care. By synthesizing current guidelines and emerging evidence, this review underscores the necessity of an integrated, multidisciplinary approach to mitigate the burden of IE and establish oral health as a key pillar of infection prevention.<\/jats:p>","DOI":"10.4081\/monaldi.2025.3497","type":"journal-article","created":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T07:36:05Z","timestamp":1748331365000},"source":"Crossref","is-referenced-by-count":1,"title":["Infective endocarditis and oral health: a long-known threat, still a challenge"],"prefix":"10.4081","volume":"96","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-6071-8796","authenticated-orcid":true,"given":"Mohamed","family":"Alsergani","sequence":"first","affiliation":[{"name":"Riyadh Elm University, Riyadh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renad Hatim","family":"Zaini","sequence":"additional","affiliation":[{"name":"Princess Nourah Bint Abdulrahman University, Riyadh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-6914-0730","authenticated-orcid":true,"given":"Naji","family":"Al Kholaif","sequence":"additional","affiliation":[{"name":"Heart Center of Excellence, King Faisal Specialist Hospital and Research Center, Riyadh; College of Medicine, Alfaisal University, Riyadh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"Al Admawi","sequence":"additional","affiliation":[{"name":"Heart Center of Excellence, King Faisal Specialist Hospital and Research Center, Riyadh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1877-8550","authenticated-orcid":true,"given":"Maria Teresa","family":"Savo","sequence":"additional","affiliation":[{"name":"Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padua"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9390-7263","authenticated-orcid":true,"given":"Dan Alexandru","family":"Cozac","sequence":"additional","affiliation":[{"name":"Physiology Department, George Emil Palade University of Medicine, Pharmacy, Science and Technology of T\u00e2rgu Mure\u0219"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-9684-6426","authenticated-orcid":true,"given":"Donatella","family":"Tansella","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Ospedale Mater Dei, Bari"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-5319-0948","authenticated-orcid":true,"given":"Basil Ali","family":"Aladani","sequence":"additional","affiliation":[{"name":"Heart Center of Excellence, King Faisal Specialist Hospital and Research Center, Riyadh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Di Michele","sequence":"additional","affiliation":[{"name":"Division of Cardiology, San Filippo Neri Hospital, Rome"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeria","family":"Pergola","sequence":"additional","affiliation":[{"name":"Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padua"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2549","published-online":{"date-parts":[[2025,5,27]]},"reference":[{"key":"57155","unstructured":"Delgado V, Ajmone Marsan N, de Waha S, et al. 2023 ESC Guidelines for the management of endocarditis. 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