Dental disease is almost entirely preventable if patients are compliant with 4 measures. First, the cause of both peri- odontal disease and caries is bacterial plaque accumulation on teeth, and prevention is dependent on keeping teeth free of plaque. Second, patients must understand that dietary mea- sures are critically important in preventing the formation of plaque, especially in areas on the teeth that are difficult to keep clean. The degree to which sugar and other refined carbohydrates are eliminated from the diet will have a major impact on the growth of pathogenic bacterial species, some of which are responsible for IE. Third, routine follow-up with their family dentist is necessary for close monitoring of oral hygiene and the early identification and eradication of oral disease. Finally, the daily use of a high-concentration fluori- dated toothpaste will help to ensure that the acid from plaque does not decalcify tooth structures and result in caries.A focus on all 4 measures should help to reduce the incidence of bac- teremia and the risk for recurrent IE. Recommendations 1. Inpatients with IE should be thoroughly evaluated by a dentist to identify and eliminate oral diseases that predispose to bacteremia and may therefore contribute to the risk for recurrent IE (Class I; Level of Evidence C). 2. The clinical examination should focus on periodon- tal inflammation and pocketing around teeth and caries that may result in pulpal infection and subse- quent abscess (Class I; Level of Evidence C). 3. A full series of intraoral radiographs will allow the identification of caries and periodontal disease and other disease (eg, tooth fractures) not evident from the physical examination. This should occur when the patient is able to travel to a dental facility (Class I; Level of Evidence C). 