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  1. Martin H Thornhill1,
  2. John B Chambers2,
  3. Mark Dayer3,
  4. Bernard D Prendergast4,
  5. Jonathan Sandoe5,
  6. Stephen Westaby4
  1. 1 Department of Oral & Maxillofacial Medicine & Surgery, The School of Clinical Dentistry, University of Sheffield, Sheffield, UK
  2. 2 Cardiothoracic Centre, Guy's and St Thomas’ Hospitals, London, UK
  3. 3 Cardiac Department, Taunton and Somerset NHS Trust, Taunton, Somerset, UK
  4. 4 Department of Cardiovascular Medicine, John Radcliffe Hospital, Oxford, UK
  5. 5 Department of Microbiology, University Hospitals, Leeds, UK
  1. Correspondence to Professor Martin Thornhill, Department of Oral & Maxillofacial Medicine & Surgery, The School Of Clinical Dentistry, University of Sheffield, Claremont Crescent, Sheffield S10 2TA, UK; m.thornhill{at}

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The Authors' reply, We would like to thank Alison Drayton, John O'Sullivan and Graham Watson for their kind comments1 regarding our editorial2 and for reinforcing the importance of maintaining good oral health and regular dental care for patients at increased risk of developing infective endocarditis, such as those with adult congenital heart disease (ACHD). Although we principally focused on cost as a barrier to such patients accessing dental care, Drayton et al also raise the issue of dental phobia as a barrier to effective dental care. In their study of 50 ACHD patients, just over one third cited anxiety/dislike of the dentist as the main reason for non-attendance at their dentist compared with 17% who mentioned cost.

We would agree that there are multiple barriers to patients attending the dentist and these will vary …

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  • Contributors MHT prepared this response and all coauthors contributed materially to its revision.

  • Competing interests None.

  • Provenance and peer review Commissioned; internally peer reviewed.

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