Sir, we are waiting impatiently for the outcome of the review of the current situation in the UK regarding antimicrobial prophylaxis against infective endocarditis (IE) and the 2008 NICE guidelines (GC64) as announced by NICE in November 2014.

The research work that has finally motivated this immediate re-evaluation has been recently published in The Lancet by a group of British and American professors in cardiology, oral medicine and infectious diseases.1 They conclude that prescriptions of antibiotic prophylaxis have fallen substantially and the incidence of IE has increased significantly in England since the introduction of the 2008 NICE guidelines. This is not just a key moment for all our dental colleagues but also a hugely inspirational event, which, once again, highlights the importance and the power of data. It reinforces the need for data collection and, I imagine, pays off all the hard work invested in a national research project of that scale.

I cannot further emphasise enough that all dental professionals should be competent on recognising the signs and symptoms of IE, remain informed about such a potentially fatal pathological entity and be aware of how its diagnosis is reached and what its initial management involves. This valuable knowledge will allow us to explain the rationale behind the current guidelines and probable future changes, better educating our patients and most importantly promoting preventive dentistry and medicine to reduce the overall risk.

Perhaps, as Bach has very rationally suggested, until more definitive trials are performed, involving patients in an informed decision-making process and individualisation of cases, in liaison with our cardiology colleagues, when antibiotic prophylaxis is considered, there seems to be a more ethical approach.2