Periodontitis, Bacteremia and Infective Endocarditis: A Review Study

Abstract

Context: Earlier evidences show that periodontitis with inflamed and ulcerated crevicular or pocket epithelium surrounding the teeth may be a portal of entry for bacteria into the bloodstream. A newly proposed causal model predicts that an early bacteremia may affect the endothelial surface of the heart over many years and promote valve thickening rendering the heart valve susceptible to vegetation by a later bacteremia that would culminate over a few weeks into fulminant infection. Evidence Acquisition: In this review, various published sources of information pertaining to periodontitis, bacteremia and infective endocarditis were reviewed. This review is focused on the role of the viridans group streptococci (VGS) in periodontitis, bacteremia and infective endocarditis. Results: The viridans group streptococci present in the oral cavity were the most important causes of bacteremia following dental procedures and infective endocarditis. In most of the studies, significantly higher rates of bacteremia occurring in patients with periodontitis than patients without periodontitis indicated that periodontitis opens up the route for oral streptococci to gain entry into the bloodstream. In addition, the significantly higher rates of isolation of the VGS from the patients of infective endocarditis with periodontitis showed that there was a positive association between periodontitis, infective endocarditis and the VGS. Conclusions:The literature survey presented in this review suggests that there is a definite relation between periodontitis, bacteremia and infective endocarditis and would provide valuable data for the future dentists as well as the physicians, because a large proportion of the world's population lives a lifetime with periodontitis. Moreover, infective endocarditis still remains a cause of concern as this disease is a cause of considerable morbidity and mortality regardless of modern antimicrobial and surgical treatment.

The Oral Bacterial Microbiome of Interdental Surfaces in Adolescents According to Carious Risk

“…A. odontolyticus has been identified in actinomycosis throughout the body [116,117]. R. dentocariosa and S. mutans are known to be associated with bacteraemia and infective endocarditis [118,119]. E. corrodens has been described in cardiovascular diseases (CVD) [120,121], and C. ochracea has also been described in lupus [122,123].…”

Quantification of carious pathogens in the interdental microbiota of young caries-free adults

“…and S . mutans are known to be associated with bacteremia and infective endocarditis [ 88 , 89 ]. Therefore, as previously demonstrated, 34.8% of young periodontally healthy subjects with ID biofilm bled [ 90 ].…”

No effects without causes: the Iron Dysregulation and Dormant Microbes hypothesis for chronic, inflammatory diseases

“…A second common origin for blood microbes is the non‐sterile oral cavity (Gargano & Hughes, ), whence they can enter through abrasive toothbrushing (Bhanji et al ., ; Tomás et al ., ) or periodontal disease. Since blood can appear in the oral cavity, there is nothing to stop the reverse process of microbial infection of the blood (Dhotre, Davane & Nagoba, ; Kilian et al ., ; Koren et al ., ) and periodontal origins represent another source of potential microbial translocation (Moon & Lee, ). There is considerable evidence for a significant association between periodontitis and RA (Bingham III & Moni, ; Cheng et al ., ; de Smit et al ., ; Detert et al ., ; Konig et al ., ; Koziel, Mydel & Potempa, ; Lee et al ., ; Martinez‐Martinez et al ., ; Mikuls et al ., ; Monsarrat et al ., ; Ogrendik, ; Potempa, Mydel & Koziel, ).…”