title: Oral Streptococcal Endocarditis, Oral Hygiene Habits, and Recent Dental Procedures: A Case-Control Study.
abstract: We aimed to compare oral hygiene habits, orodental status, and dental procedures in patients with infective endocarditis (IE) according to whether the IE-causing microorganism originated in the oral cavity.
  We conducted an assessor-blinded case-control study in 6 French tertiary-care hospitals. Oral hygiene habits were recorded using a self-administered questionnaire. Orodental status was analyzed by trained dental practitioners blinded to the microorganism, using standardized clinical examination and dental panoramic tomography. History of dental procedures was obtained through patient and dentist interviews. Microorganisms were categorized as oral streptococci or nonoral pathogens using an expert-validated list kept confidential during the course of the study. Cases and controls had definite IE caused either by oral streptococci or nonoral pathogens, respectively. Participants were enrolled between May 2008 and January 2013.
  Cases (n = 73) were more likely than controls (n = 192) to be aged <65 years (odds ratio [OR], 2.85; 95% CI, 1.41-5.76), to be female (OR, 2.62; 95% CI, 1.20-5.74), to have native valve disease (OR, 2.44; 95% CI, 1.16-5.13), to use toothpicks, dental water jet, interdental brush, and/or dental floss (OR, 3.48; 95% CI, 1.30-9.32), and to have had dental procedures during the prior 3 months (OR, 3.31; 95% CI, 1.18-9.29), whereas they were less likely to brush teeth after meals. The presence of gingival inflammation, calculus, and infectious dental diseases did not significantly differ between groups.
  Patients with IE caused by oral streptococci differ from patients with IE caused by nonoral pathogens regarding background characteristics, oral hygiene habits, and recent dental procedures, but not current orodental status.
authors.affiliation: Inserm CIC-1425, AP-HP, Hôpital Universitaire Bichat; Inserm UMR-1137 IAME; Université Paris Diderot, UFR de Médecine-Bichat, and.
authors.forename: Xavier
authors.initials: X
authors.lastname: Duval
authors.affiliation: UMR 1149-Inserm, CRI, Université Paris Diderot, Faculté de médecine Bichat, Paris.
authors.forename: Sarah
authors.initials: S
authors.lastname: Millot
authors.affiliation: UMR 6249 Laboratoire Chrono-environnement Université de Bourgogne Franche-Comté, Service de maladies infectieuses, CHRUBesançon.
authors.forename: Catherine
authors.initials: C
authors.lastname: Chirouze
authors.affiliation: Centre Hospitalier Régional Universitaire, and.
authors.forename: Christine
authors.initials: C
authors.lastname: Selton-Suty
authors.affiliation: Service Odontologie-Centre Hospitalier Régional Universitaire Nancy.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Moby
authors.affiliation: Maladies Infectieuses et Réanimation Médicale, Centre Hospitalier Universitaire, Rennes.
authors.forename: Pierre
authors.initials: P
authors.lastname: Tattevin
authors.affiliation: Cabinet d'infectiologie, Clinique Saint André-Groupe Courlancy, Reims.
authors.forename: Christophe
authors.initials: C
authors.lastname: Strady
authors.affiliation: Inserm, CIC-1431; Service de Stomatologie, Chirurgie Maxillofaciale et Odontologie Hospitalière, CHRU Besançon.
authors.forename: Edouard
authors.initials: E
authors.lastname: Euvrard
authors.affiliation: Inserm, CIC-1433 Epidémiologie Clinique, Centre Hospitalier Régional Universitaire, Nancy.
authors.forename: Nelly
authors.initials: N
authors.lastname: Agrinier
authors.affiliation: AP-HP, Hôpital Pitié-Salpêtrière, Département de Cardiologie, Paris.
authors.forename: Daniel
authors.initials: D
authors.lastname: Thomas
authors.affiliation: Université des Antilles et de la Guyane, Faculté de Médecine Hyacinthe Bastaraud, EA 4537; Centre Hospitalier Universitaire de Pointe-à-Pitre, Inserm CIC-1424, Service de Maladies Infectieuses et Tropicales, Dermatologie, Médecine Interne, Pointe-à-Pitre; and.
authors.forename: Bruno
authors.initials: B
authors.lastname: Hoen
authors.affiliation: Université de Lorraine, Université Paris Descartes, Apemac, EA4360; Inserm, CIC-1433, Nancy, France.
authors.forename: François
authors.initials: F
authors.lastname: Alla
mesh_terms: D000328:Adult; D000368:Aged; D016470:Bacteremia / Q000188:drug therapy; D001419:Bacteria / Q000145:classification / Q000302:isolation & purification; D016022:Case-Control Studies; D003813:Dentistry; D004697:Endocarditis, Bacterial / Q000209:etiology* / Q000382:microbiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009055:Mouth / Q000382:microbiology*; D016017:Odds Ratio; D009910:Oral Hygiene; D012307:Risk Factors; D013290:Streptococcal Infections / Q000209:etiology* / Q000382:microbiology; D013291:Streptococcus / Q000145:classification / Q000302:isolation & purification*
keywords: case-control study; dental status.; endocarditis; hygiene; prophylaxis