Poor dental hygiene and periodontal or periapical infections may produce bacteremia even in the absence of dental procedures. The incidence and magnitude of bacteremias of oral origin are directly proportional to the degree of oral inflammation and infection. Individuals who are at risk for developing bacteria endocarditis should establish and maintain the best possible oral health to reduce potential sources of bacterial seeding. Optimal oral health is maintained through regular professional care and the use of appropriate dental products such as manual and powered toothbrushes, dental floss, and other plaque-removal devices. Oral irrigator or air abrasive polishing devices used inappropriately or in patients with poor oral hygiene have been implicated in producing bacteremia, but the relationship to bacterial endocarditis is unknown. Home-use devices pose far less risk of bacteremia in a healthy mouth than does ongoing oral inflammation.

Antiseptic mouth rinses applied immediately prior to dental procedures may reduce the incidence or magnitude of bacteremia. Agents include chlorhexidine hydrochloride and povidone-iodine. Fifteen minutes of chlorhexidine can be given to all at-risk patients via gental oral rinsing for about 30 seconds prior to dental treatment; gingival irrigation is not recommended. Sustained or repeated frequent interval use is not indicated as this may result in the selection of resistant micro-organisms.