Bacteraemia due to dental flossing.
OBJECTIVE
The aims of this study were to (1) investigate the incidence of bacteraemia following flossing in subjects with chronic periodontitis or periodontal health; (2) identify the micro-organisms in detected bacteraemias; and (3) identify any patient or clinical factors associated with such bacteraemia.


METHODS
Baseline blood samples were obtained from 30 individuals with chronic periodontitis (17 M:13 F, 29-75 years) and 30 with periodontal health (17 M:13 F, 28-71 years) following a non-invasive examination. Each subject's teeth were then flossed in a standardized manner and blood samples obtained 30 s and 10 min. after flossing cessation. Blood samples were cultured in a BACTEC system and positive samples subcultured for identification.


RESULTS
Forty per cent of periodontitis subjects and 41% of periodontally healthy subjects tested positive for bacteraemia following flossing. Viridans streptococci, which are commonly implicated in infective endocarditis (IE), were isolated from 19% of positive subjects and accounted for 35% of microbial isolates. Twenty per cent of subjects had a detectable bacteraemia at 10 min. post-flossing. No patient or clinical factors were significantly associated with post-flossing bacteraemia.


CONCLUSIONS
Dental flossing can produce bacteraemia in periodontally healthy and periodontally diseased individuals at a rate comparable with that caused by some dental treatments for which antibiotic prophylaxis is given to prevent IE.
Discipline of Periodontics, Faculty of Dentistry, University of Sydney, NSW, Australia.
Kenneth
K
Crasta
Christopher G
CG
Daly
David
D
Mitchell
Brad
B
Curtis
Douglas
D
Stewart
Lisa J A
LJ
Heitz-Mayfield
D000328:Adult; D000368:Aged; D019072:Antibiotic Prophylaxis / Q000706:statistics & numerical data; D016470:Bacteremia / Q000209:etiology* / Q000382:microbiology; D016022:Case-Control Studies; D055113:Chronic Periodontitis / Q000628:therapy*; D003742:Dental Devices, Home Care / Q000009:adverse effects*; D003774:Dental Plaque Index; D003777:Dental Prophylaxis / Q000009:adverse effects* / Q000295:instrumentation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010512:Periodontal Index; D010518:Periodontitis / Q000517:prevention & control; D015203:Reproducibility of Results; D034363:Viridans Streptococci / Q000302:isolation & purification