Intensity of bacteraemia associated with conservative dental procedures in children

Infective Endocarditis in Childhood: 2015 Update

“…42,44,46,[51][52][53] Of the more than 100 oral bacterial species recovered from blood cultures in children after dental procedures, the number and variety of species reflect the spectrum of oral flora in health and disease (Table 2). They also reflect the varied microbiological methodologies used in these studies (eg, culture-based rather than molecular), with the recognition that many bacterial species clearly enter the bloodstream but are not cultivable and therefore not recorded.…”

“…[40][41][42][43][44][45][46][47][48] Multiple clinical studies of children over the past 40 years focused on the impact of ≥1 of the following risks for development of bacteremia: class of prophylactic antibiotic drug 49 ; nature and invasiveness of dental procedures 42,[44][45][46][47][49][50][51][52][53] ; indices of oral hygiene and disease 41,45,48,49,51,54,55 ; timing of blood culture draws before, during, and after the dental procedure 45,48,56 ; various methods of microbial analysis and identification 44,57 ; and the impact of these variables on surrogate measures of risk for IE, such as the incidence, duration, nature, and magnitude of bacteremia. [44][45][46][47][48] Clearly, these surrogate measures are also influenced by multiple host factors.…”

Infective endocarditis, dentistry and antibiotic prophylaxis; time for a rethink?

“…Contemporary studies employing rigorous microbiological techniques 20,21 have yielded more positive blood cultures, and even the application of rubber dam was recently shown in children to produce bacteraemia of comparable magnitude to a dental extraction. 22 Highly sensitive, molecular methods have yet to be applied in the identification and sourcing of cultivable and non-cultivable microbes in the circulation after careful endodontic treatment. It is likely that a wide variety of organisms would be detected, though their significance with respect to infective endocarditis is not known.…”

Knowledge and practice of antibiotic prophylaxis for infective endocarditis among dental students

“…Antibiotic Prophylaxis is provided to prevent the development of bacterial endocarditis as a consequence of odontogenicbacteraemia. 13 Two mechanisms are thought to be responsible. First a reduction in the numbers of organisms in the blood and second a reduction in the adhesion of organisms to the nonbacterial thrombotic vegetation.…”