Bacteraemia due to dental flossing

Abstract

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.

Association of natural anti-platelet factor 4/heparin antibodies with periodontal disease

“…16,17 This especially happens during mastication 17 or daily oral hygiene measures. 18,19 Lockhart et al found bacteremia in 28% of individuals immediately after tooth brushing, and in 79% after tooth extraction. 19 It is therefore very likely that bacteremia occurs frequently in individuals with periodontitis.…”

Induction of Experimental Endocarditis by Continuous Low-Grade Bacteremia Mimicking Spontaneous Bacteremia in Humans

“…Although it is true that dental or other surgical procedures may cause bacteremia (16,29), routine daily events, such as mastication and tooth brushing, can also result in bacteremia as well (1,11,(19)(20)(21)29). It was estimated that the cumulative numbers of circulating bacteria (in CFU/ml/year) resulting from either mastication, tooth brushing two times daily or mere dental examination, were up to 5.6 million times, 154,000 times, and 48 times greater than that provoked by a single tooth extraction (14,32,42,43).…”

Antibiotic prophylaxis for dental procedures

“…9 However, the incidence of bacteraemia with flossing does not differ significantly between people with or without periodontal disease. 10 The incidence and magnitude of bacteraemia caused by flossing are the same as that caused by deep scaling/root planing within the same…”