Streptococcus mitis infective endocarditis in a patient with ventricular septal defect and orthodontic appliances.

We describe a case of a girl in a remote and rural location in Scotland with a perimembranous ventricular septal defect and orthodontic appliances, who developed right-sided infective endocarditis from Streptococcus mitis due to abrasion of the oral mucosa from the arch wire following its adjustment in the dental clinic.Fitting and adjustment of orthodontic appliances are not considered to be high-risk dental procedures and antibiotic prophylaxis is not recommended even for patients at highest risk for infective endocarditis.