Sir, I would like to thank the authors of NICE clinical guideline 64 'Prophylaxis against infective endocarditis', for clearly stating that 'antibiotic prophylaxis against infective endocarditis is not recommended for people undergoing dental procedures'.1 Whilst the wholesale ending of antibiotic prophylaxis for dental procedures, regardless of perceived risk of IE, will prove controversial in some circles, the detailed analyses of the evidence in the document shows no convincing evidence of benefit to patients, and that there are real risks from anaphylaxis and antimicrobial resistance. Hopefully the profession will take this guidance on board, and begin the difficult process of educating our patients and medical colleagues as to why 50 years of dogma has been turned on its head.