Revised guidelines for the prevention of infective endocarditis published by national and international associations in the last years do not support the indiscriminate use of antibiotic prophylaxis for dental procedures. However, some of them still recommend its use in high-risk patients before dental treatments likely to cause bleeding. Given the high prevalence of bacteremia of dental origin due to tooth-brushing, mastication or other daily activities, it appears unlikely that infective endocarditis from oral microorganisms can be completely prevented. A good oral health status and satisfactory level of oral hygiene are sufficient to control the consequences of the systemic spread of oral microorganisms in healthy individuals. However, caution is still needed and prophylactic antibiotics must be administered to susceptible or medically compromised patients. This review briefly outlines the current concepts of odontogenic bacteremia and antibiotic prophylaxis for patients undergoing dental treatment.