Aims: The aims of this study were to (1) investigate the incidence of bacteraemia following flossing in subjects with chronic periodontitis or periodontal health; (2) identify the micro‐organisms in detected bacteraemias; and (3) identify any patient or clinical factors associated with such bacteraemia. Material and Methods: Baseline blood samples were obtained from 30 individuals with chronic periodontitis (17 M:13 F, 29–75 years) and 30 with periodontal health (17 M:13 F, 28–71 years) following a non‐invasive examination. Each subject's teeth were then flossed in a standardized manner and blood samples obtained 30 s and 10 min. after flossing cessation. Blood samples were cultured in a BACTEC™ system and positive samples subcultured for identification. Results: Forty per cent of periodontitis subjects and 41% of periodontally healthy subjects tested positive for bacteraemia following flossing. Viridans streptococci, which are commonly implicated in infective endocarditis (IE), were isolated from 19% of positive subjects and accounted for 35% of microbial isolates. Twenty per cent of subjects had a detectable bacteraemia at 10 min. post‐flossing. No patient or clinical factors were significantly associated with post‐flossing bacteraemia. Conclusions: Dental flossing can produce bacteraemia in periodontally healthy and periodontally diseased individuals at a rate comparable with that caused by some dental treatments for which antibiotic prophylaxis is given to prevent IE.

The present case report outlines the interdisciplinary management of an adult patient presenting with advanced generalised periodontal attachment loss, an upper dental midline discrepancy following the previous extraction of the upper left central incisor, and significant lower arch crowding. The endodontic and periodontal condition was stabilised prior to the commencement of fixed appliance orthodontic treatment and subsequent prosthetic replacement of the upper left central incisor. Interdisciplinary management provided a functional occlusion and stability of the periodontal condition along with pleasing facial and smile aesthetics.