The central indwelling venous catheter in the pediatric patient—dental treatment considerations

Abstract

Dentists need to understand and recognize the special needs of this unique patient population before dental therapy is instituted. The primary objective of this paper is to familiarize the dental practitioner with the central venous catheter and its indications in pediatric medicine. In addition, recommendations concerning the appropriate management of these patients are provided.

Oral complications of pediatric hematopoietic cell transplantation: diagnosis and management itioning/immune suppression to initial engraftment

“…The incidence and significance of catheter colonization by "organisms of oral origin" have not been systematically investigated; the bulk of catheter infections appear to be clearly associated with staphylococcal species felt to be of oral origin. The only report in the Literature suggesting that antibiotics are necessary was based on non-scientific opinions and empiric protocols [39] While the authors have heard anecdotal reports of Hickman lines becoming infected by "oral" organisms in pediatric patients who have had lines in place for several years, these cases were also not subjected to appropriate scientific scrutiny to prove the source of organisms, which would have fitted them for use as the basis for antibiotic prophylaxis for dental treatment procedures. However, until valid scientific proof is established, we have adopted the conservative policy of utilizing the American Heart Association's guidelines for antibiotic prophylaxis to prevent bacterial endocarditis prior to dental procedures at risk to cause bacteremia (Table 3).…”

Oral-Dental Concerns of the Pediatric Oncology Patient

“…Abscessed teeth should be removed before catheter placement. Intraoral infection must be treated aggressively (12). The American Heart Association endocarditis prophylaxis regimen should be used in patients with indwelling catheters.…”

Oral health, dental prophylaxis and catheter related bloodstream infections in home parenteral nutrition patients: results of a UK survey and cohort study

“…12,13 Concern among physicians to mitigate the risk of CRBSI from dental procedural bacteraemia results in the recommendation of antibiotic prophylaxis. 14 Prophylaxis recommendations for dental treatment in central venous catheter populations [15][16][17] are at odds with the British Society for Antimicrobial Chemotherapy view that there is a lack of evidence supporting routine prophylaxis to prevent CRBSI.…”