Bacteraemia following periodontal procedures.
BACKGROUND
Transient bacteraemias are frequently detected following dental manipulation. Infective endocarditis (IE) can arise in susceptible individuals and antibiotic prophylaxis is routinely performed for certain procedures considered to be "at risk" of IE. Evidence is emerging that periodontal disease may be a significant risk factor for the development of certain systemic diseases such as cardiovascular disease. These systemic conditions could be initiated or detrimentally influenced by the repeated entry of bacteria into the bloodstream.


METHODS
The present study comprised a single blind parallel study of 2 weeks duration. A baseline blood sample was obtained from 30 volunteers with untreated periodontal disease following which a periodontal probing depth chart was collected. A further blood sample was taken following this procedure, and each subject was recalled 2 weeks later. A blood sample was collected, the subject carried out toothbrushing and a further blood sample taken. Full-mouth ultrasonic scaling was then performed and a final blood sample taken. Blood samples were analysed for bacteraemia using conventional microbiological culture and polymerase chain reaction (PCR) using universal bacterial primers that target the 16S ribosomal RNA gene of the vast majority of bacteria.


RESULTS
Using culture methods, the incidence of bacteraemias was as follows: following ultrasonic scaling (13%), periodontal probing (20%) and toothbrushing (3%). PCR analysis revealed bacteraemia incidences following ultrasonic scaling, periodontal probing and toothbrushing of 23%, 16% and 13%, respectively.


CONCLUSIONS
These findings suggest that detectable dental bacteraemias induced by periodontal procedures are at a lower level than previously reported.
Kinane
Denis F
DF
University of Louisville School of Dentistry, Louisville, KY 40292, USA. dfkina01@louisville.edu
Riggio
Marcello P
MP
Walker
Katie F
KF
MacKenzie
Duncan
D
Shearer
Barbara
B
D000328:Adult; D016470:Bacteremia / Q000209:etiology*; D001421:Bacteria, Anaerobic / Q000302:isolation & purification; D015169:Colony Count, Microbial; D003762:Dental Instruments / Q000009:adverse effects*; D012534:Dental Scaling / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010517:Periodontics / Q000295:instrumentation; D010518:Periodontitis / Q000628:therapy*; D016133:Polymerase Chain Reaction; D012329:RNA, Bacterial / Q000032:analysis; D012335:RNA, Ribosomal / Q000032:analysis; D016037:Single-Blind Method; D014099:Toothbrushing / Q000009:adverse effects; D014464:Ultrasonic Therapy / Q000009:adverse effects
D012329:RNA, Bacterial; D012335:RNA, Ribosomal