QLexNursing

🦷Streptococcus viridans (alpha-hemolytic streptococci) are normal oral flora that can enter the bloodstream during gingival manipulation (e.g., toothbrushing, flossing, dental procedures) and are a leading cause of community-acquired infective endocarditis (IE), especially in individuals with pre-existing valvular lesions.

🦷Once in the blood, viridans streptococci produce dextran-rich biofilms that bind to platelet-fibrin deposits on damaged endocardium or prosthetic material, forming vegetations that impair valve function and can embolize to the brain, spleen, kidneys, or coronaries.

🦷Poor oral hygiene and untreated periodontal disease increase gingival inflammation and bacteremia frequency, which raises IE risk in predisposed clients (e.g., prosthetic heart valves, prior IE, certain congenital heart diseases, cardiac transplant with valvulopathy).

🦷Routine dental care (professional cleanings, cavity management, periodontal therapy) combined with daily brushing and flossing reduces oral bacterial load, thereby lowering bacteremia episodes and subsequent valvular seeding by S. viridans.

🦷For high-risk cardiac conditions only, antibiotic prophylaxis is recommended before dental procedures that manipulate gingiva, periapical tissue, or perforate oral mucosa; commonly amoxicillin 2 g PO 30–60 min prior (with evidence-based alternatives if penicillin-allergic per current guidance).

🦷Client teaching should stress “everyday prevention”: meticulous twice-daily brushing, daily interdental cleaning, regular dental visits, and prompt treatment of oral infections, which have greater impact on IE prevention than a single antibiotic dose.

🦷Because S. viridans originates from the mouth, preventive efforts must focus on the oral portal of entry; by contrast, pathogens like Staphylococcus aureus often relate to skin/line infections or IVDU, underscoring why dental hygiene is uniquely critical for viridans-mediated IE.