Post‐tooth extraction sepsis without locoregional infection – a population‐based study in Taiwan

Abstract

Tooth extraction is associated with a low but significant risk of postoperative sepsis, especially in the elderly and patients with underlying diseases.

'An unusual response of dental sepsis to antibiotics: parallels with the Jarisch-Herxheimer reaction'

“…Although this group of organisms are identified as an oropharyngeal commensal, their ability to produce thick pus and form abscesses are well documented 16–18 . S milleri abscess formations are known to occur at multiple body sites, with one report demonstrating that S milleri was the most common organism from the Streptococcus viridans group associated with abscess formation accounting for 71% of brain abscesses, 40% of abdominal abscesses and 34% of extra-abdominal abscesses 17–19. Disruption of the mucosal barrier, such as post tooth extraction, allows for invasion into underlying tissues and local spread as well as the potential for the organisms to spread haematogenously causing metastatic abscesses 17 19 20.…”

“…S milleri abscess formations are known to occur at multiple body sites, with one report demonstrating that S milleri was the most common organism from the Streptococcus viridans group associated with abscess formation accounting for 71% of brain abscesses, 40% of abdominal abscesses and 34% of extra-abdominal abscesses 17–19. Disruption of the mucosal barrier, such as post tooth extraction, allows for invasion into underlying tissues and local spread as well as the potential for the organisms to spread haematogenously causing metastatic abscesses 17 19 20. Abscesses caused by S constellatus are more likely to be polymicrobial, with the co-isolates reflecting the site from which the specimen was obtained 20 21…”

Antibiotic susceptibility of 33 Prevotella strains isolated from Romanian patients with abscesses in head and neck spaces

“…P. intermedia, P. nigrescens, P. pallens, P. oris) are among the most dominant and prevalent bacteria isolated from dental abscesses and their severe complications due to bacterial spreading [11,12], as: brain [13,14], liver [15] or lung abscesses [16], mediastinitis [17], necrotizing fasciitis [17,l8], Ludwig's angina [19] and sepsis [20]. In facial cellulitis of dental origin, Prevotella was reported as the most frequently isolated anaerobic bacteria [21].…”

Analysis of the attitudes and needs/demands of dental practitioners in the field of patient safety and risk management

“…Improving the quality of dental prescriptions is suggested to reduce the risks for medication errors and to promote the rational use of pharmacotherapy, and patient safety. In a population‐based study, tooth extraction was shown to be associated with a low but significant risk of postoperative sepsis, especially in the elderly and patients with underlying diseases. Further, owing to the danger of trans‐infection of blood‐borne diseases, dental practitioners are recommended to assess the risks of cross‐infection after dental extraction.…”

“…Such reporting and analysis of errors can significantly help in the identification of the main contributing factors. According to all these studies, understanding the factors that lead to errors is essential for the consideration of changes that will prevent errors. It also needs to be considered that single events or errors most often result from the convergence of multiple contributing factors and preventing errors apparently requires a systems approach in order to modify the conditions that contribute to these errors.…”