IE Prophylaxis Uncertainty — ORE Part 1 MCQ

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ModeratePharmacology & TherapeuticsIE Prophylaxis UncertaintyORE Part 1

Before an at-risk dental procedure, a dentist cannot determine from the available history whether a patient’s cardiac condition places them at high or moderate risk of infective endocarditis. According to current SDCEP implementation advice, what is the most appropriate action?

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Correct answer: B — Contact the cardiac team and make a shared decision with the patient

Explanation lettering: C = shown as A · A = shown as B · D = shown as C · B = shown as D

A is correct. Current SDCEP advice states that if the dental team cannot establish whether the patient has a high- or moderate-risk cardiac condition, it should contact the patient’s cardiology or cardiac surgery team to clarify the condition and whether prophylaxis is recommended. The subsequent decision must involve shared decision-making with the patient, considering the procedure, potential benefits and harms, oral health, and the patient’s preferences. B and C are inappropriate blanket policies: prophylaxis is neither indicated for all cardiac disease nor withheld irrespective of risk. D wrongly treats patient request alone as an indication. E is unsafe because risk classification is a clinical assessment and may require confirmation from the cardiac team.

Reference: Scottish Dental Clinical Effectiveness Programme. Antibiotic Prophylaxis Against Infective Endocarditis: Implementation Advice, 2nd edition, March 2026, “Advice for cardiology and cardiac surgery teams”. https://www.antibioticprophylaxis.sdcep.org.uk/implementation-advice/advice-for-cardiology-and-cardiac-surgery-teams/