Incidence of Bacteremia after Routine Tooth Brushing

Hartzell, Joshua D.; Torres, Dawn M.; Kim, Peter; Wortmann, Glenn

doi:10.1097/00000441-200504000-00003

Cited by 55 publications

(78 citation statements)

References 17 publications

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“…Primary SEA has been reported to arise by haematogenous spread from skin lesions and from oral [3,6,11,16,17] and enteric foci, including bowel perforation in inflammatory bowel disease [18,19], as well as from injections and infusion therapy at distant sites [15]. We found primary SEA of all these types among our patients.…”

Section: Discussionsupporting

confidence: 53%

“…So-called primary SEA is due to the haematogenous spread of pathogens from a distant focus of infection into the spinal epidural space. Microorganisms are normally eliminated from the bloodstream in minutes by the reticuloendothelial system [3]; under certain conditions, however, they can settle and proliferate far away from their site of origin, giving rise to a local primary infection, such as SEA. The risk of SEA is higher in immunocompromised persons, e.g., persons who have the acquired immune deficiency syndrome (AIDS) or are under immunosuppressive treatment after organ transplantation [4].…”

Section: Introductionmentioning

confidence: 99%

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Spinal epidural abscess: aetiology, predisponent factors and clinical outcomes in a 4-year prospective study

et al. 2011

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Spinal epidural abscess (SEA) is a rare, but serious, condition with multiple causes. We prospectively studied the aetiology, predisposing factors, and clinical outcomes of SEA in all patients with SEA treated in our hospital's neurosurgical service from 2004 to 2008. For each patient, we recorded the medical history, comorbidities, focus of infection, pathogen(s), and outcome. The 36 patients (19 women and 17 men) ranged in age from 34 to 80 years old (mean 57; median 56). The SEA was primary (i.e., due to haematogenous spread) in 16 patients (44%); it was secondary to elective spinal procedures, either injections or surgery, in 20 patients (56%). The duration of follow-up was 12-60 months (mean 36; median 37.5). The most common pathogen, Staphylococcus aureus, was found in 18 patients (50%). Patients with primary SEA had different underlying diseases and a wider range of pathogens than those with secondary SEA. Only five patients (14%) had no major comorbidity; 16 of the 20 patients with secondary SEA (44% of the overall group) had undergone spinal surgery before developing the SEA; the treatment of the SEA involved multiple surgical operations in all 16 of these patients, and spinal instrumentation in 5 (14%); 22 patients (61% of the overall group) recovered fully.

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Section: Discussionsupporting

confidence: 53%

Section: Introductionmentioning

confidence: 99%

Spinal epidural abscess: aetiology, predisponent factors and clinical outcomes in a 4-year prospective study

et al. 2011

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“…[13][14][15][16][17] The other 2 reports were published after patient enrollment for the present study. 18,19 These 7 reports had a range in the number of subjects from 20 to 30, and they had a wide range of bacteremia incidence. Only 1 of these reports measured bacteremia Ͼ20 minutes after brushing.…”

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confidence: 99%

Bacteremia Associated With Toothbrushing and Dental Extraction

et al. 2008

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Background-Antibiotic prophylaxis recommendations for the prevention of infective endocarditis are based in part on studies of bacteremia from dental procedures, but toothbrushing may pose a greater threat. The purpose of this study was to compare the incidence, duration, nature, and magnitude of endocarditis-related bacteremia from single-tooth extraction and toothbrushing and to determine the impact of amoxicillin prophylaxis on single-tooth extraction. Methods and Results-In this double-blind, placebo-controlled study, 290 subjects were randomized to (1) toothbrushing, (2) single-tooth extraction with amoxicillin prophylaxis, or (3) single-tooth extraction with identical placebo. Blood was drawn for bacterial culturing and identification at 6 time points before, during, and after these interventions. The focus of our analysis was on bacterial species reported to cause infective endocarditis. We identified 98 bacterial species, 32 of which are reported to cause endocarditis. Cumulative incidence of endocarditis-related bacteria from all 6 blood draws was 23%, 33%, and 60% for the toothbrushing, extraction-amoxicillin, and extraction-placebo groups, respectively (PϽ0.0001). Significant differences were identified among the 3 groups at draws 2, 3,4, and 5 (all PϽ0.05). Amoxicillin resulted in a significant decrease in positive cultures (PϽ0.0001). Conclusions-Although amoxicillin has a significant impact on bacteremia resulting from a single-tooth extraction, given the greater frequency for oral hygiene, toothbrushing may be a greater threat for individuals at risk for infective endocarditis. (Circulation. 2008;117:3118-3125.)

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“…6 Some reports have addressed that toothbrushing itself can cause bacteremia 2 and some others not. 3 There is not much information on how to deal with low grade but frequent bacteremia related to everyday events like toothbrushing 12,13,32 or flossing, 33 which have almost the same occurrence rate as dental treatment induced bacteremia and for which antibiotic prophylaxis can not be prescribed. Since bacteremia of this nature is unavoidable, at risk patients and their dental care providers should focus on ways of reducing the number of oral bacteria entering the bloodstream during these activities.…”

Section: Discussionmentioning

confidence: 99%

“…2 It even can occur in healthy populations with manipulation of the oral mucosa, including toothbrushing. 3 Lucas et al 4 compared baseline values of bacteremia with different types of toothbrushing techniques such as (1) Oral B 30 toothbrush, (2) Braun, (3) Sonicare electric toothbrush or (4) dental handpiece and rubber cup. They found significantly greater aerobic and anaerobic intensity of bacteremia following brushing with both the Sonicare (p = 0.03 and p = 0.05) and the dental handpiece (p = 0.001 and p = 0.005).…”

Section: Introductionmentioning

confidence: 99%

Investigation of bacteremia after toothbrushing in orthodontic patients

et al. 2009

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Objective: The aim of this study was to investigate the occurrence rate of bacteremia following toothbrushing with toothpastes composed of several antibacterial agents and compare the results with the conventional oral hygiene maintaining methods in orthodontic patients. Methods: This clinical study included 100 adult orthodontic patients who were divided into 4 groups. Each group comprised of 25 patients, wearing fixed orthodontic appliances. In the first group, bacteremia was assessed after toothbrushing without using any toothpaste. In the second group, a 0.2% chlorhexidine gluconate mouthrinse was used before brushing with no toothpaste. In the third group, subjects brushed with a commonly used toothpaste which did not include an additional antimicrobial agent. The fourth experimental group used toothpaste which included tea tree oil, clove oil, peppermint oil and bisabolol as antimicrobial elements. Pre-and post-brushing blood samples were obtained using a strict aseptic technique. All samples were microbiologically evaluated using blood culture bottles. Results: Toothbrushing in orthodontic patients yielded to an increase in the occurrence rate of bacteremia when using normal toothpaste or no toothpaste at all. Conclusions: The use of chlorhexidine mouthwash before toothbrushing, and brushing with antimicrobial toothpaste did not show a statistically significant difference in preventing the occurrence of bacteremia (p ＞ 0.05).

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Incidence of Bacteremia after Routine Tooth Brushing

Cited by 55 publications

References 17 publications

Spinal epidural abscess: aetiology, predisponent factors and clinical outcomes in a 4-year prospective study

Spinal epidural abscess: aetiology, predisponent factors and clinical outcomes in a 4-year prospective study

Bacteremia Associated With Toothbrushing and Dental Extraction

Investigation of bacteremia after toothbrushing in orthodontic patients

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