The oral consequences of opioid drug use are commonly attributed to personal neglect of general health and financial constraint. These factors are compounded by the increasingly recognized range of physical effects exerted by opioid drugs. The dental management of opioid drug dependents is further complicated by a variety of infections and behavioural modifications commonly associated with opioid use. Adequate strategies for the oral care of opioid users need to take cognisance of the broad medical issues for these people along with an appropriate personal approach.

Oral commensal microorganisms are commonly associated with the pathogenesis of infective endocarditis. Despite modern antimicrobial and surgical treatment, infective endocarditis continues to cause substantial morbidity and mortality. Although dentistry is no longer considered a major risk factor for infective endocarditis, it is current standard for practice that dental procedures likely to produce significant bacteraemia in patients who are susceptible to this disease be prophylactically covered with an antimicrobial agent. The concepts of antimicrobial prophylaxis prior to invasive dental procedures are outlined in this review, with particular reference to the latest recommendations of the Australian Dental Association.