Toothbrushing and transient bacteremia in patients undergoing orthodontic treatment

Schlein, Richard A.; Kudlick, Earl M.; Reindorf, Carl A.; Gregory, James E.; Royal, George C.

doi:10.1016/s0889-5406(05)81580-x

Cited by 72 publications

(82 citation statements)

References 27 publications

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“…On the other hand, subjects wearing orthodontic appliances demonstrated bacteremias of odontogenic origin following toothbrushing, with an incidence of 25% (119). For children, there is some evidence to indicate that bacteremias ensue upon toothbrushing performed under general anesthesia and nasotracheal intubation.…”

Section: Personal Oral Hygiene Measuresmentioning

confidence: 99%

Microbiology of Odontogenic Bacteremia: beyond Endocarditis

et al. 2009

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SUMMARY The human gingival niche is a unique microbial habitat. In this habitat, biofilm organisms exist in harmony, attached to either enamel or cemental surfaces of the tooth as well as to the crevicular epithelium, subjacent to a rich vascular plexus underneath. Due to this extraordinary anatomical juxtaposition, plaque biofilm bacteria have a ready portal of ingress into the systemic circulation in both health and disease. Yet the frequency, magnitude, and etiology of bacteremias due to oral origin and the consequent end organ infections are not clear and have not recently been evaluated. In this comprehensive review, we address the available literature on triggering events, incidence, and diversity of odontogenic bacteremias. The nature of the infective agents and end organ infections (other than endocarditis) is also described, with an emphasis on the challenge of establishing the link between odontogenic infections and related systemic, focal infections.

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Section: Personal Oral Hygiene Measuresmentioning

confidence: 99%

Microbiology of Odontogenic Bacteremia: beyond Endocarditis

et al. 2009

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“…6 Some reports have addressed that toothbrushing itself can cause bacteremia 2 and some others not. 3 There is not much information on how to deal with low grade but frequent bacteremia related to everyday events like toothbrushing 12,13,32 or flossing, 33 which have almost the same occurrence rate as dental treatment induced bacteremia and for which antibiotic prophylaxis can not be prescribed. Since bacteremia of this nature is unavoidable, at risk patients and their dental care providers should focus on ways of reducing the number of oral bacteria entering the bloodstream during these activities.…”

Section: Discussionmentioning

confidence: 99%

“…13 All of these factors were carefully evaluated when designing the present study. Blood was collected from the antecubital fossa, which was reported to yield colony counts only slightly lower than arterial blood.…”

Section: Discussionmentioning

confidence: 99%

“…It was shown in animal experiments that 10 3 to 10 9 colony forming units of bacteria per milliliter of blood was required to induce infective endocarditis. 6 In the studies on bacteremia related to toothbrushing in orthodontic patients by Chung et al 12 and Schlein et al 13 subjects used toothbrush without toothpaste and none used chlorhexidine or any antiseptic before toothbrushing. In the present study, the control group performed as in the previous studies, but in an effort to simulate the normal situation of the patients, the subjects in the third group were asked to brush their teeth with commonly used toothpaste.…”

Section: Discussionmentioning

confidence: 99%

“…However, it should be noted that they also detected bacteremia in 10 patients before toothbrushing. Schlein et al 13 studied bacteremia occurring after toothbrushing in twenty patients undergoing orthodontic treatment with fixed appliances and reported that 25% of the sample had positive blood tests after brushing. Lucas et al 14 …”

Section: Introductionmentioning

confidence: 99%

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Investigation of bacteremia after toothbrushing in orthodontic patients

et al. 2009

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Objective: The aim of this study was to investigate the occurrence rate of bacteremia following toothbrushing with toothpastes composed of several antibacterial agents and compare the results with the conventional oral hygiene maintaining methods in orthodontic patients. Methods: This clinical study included 100 adult orthodontic patients who were divided into 4 groups. Each group comprised of 25 patients, wearing fixed orthodontic appliances. In the first group, bacteremia was assessed after toothbrushing without using any toothpaste. In the second group, a 0.2% chlorhexidine gluconate mouthrinse was used before brushing with no toothpaste. In the third group, subjects brushed with a commonly used toothpaste which did not include an additional antimicrobial agent. The fourth experimental group used toothpaste which included tea tree oil, clove oil, peppermint oil and bisabolol as antimicrobial elements. Pre-and post-brushing blood samples were obtained using a strict aseptic technique. All samples were microbiologically evaluated using blood culture bottles. Results: Toothbrushing in orthodontic patients yielded to an increase in the occurrence rate of bacteremia when using normal toothpaste or no toothpaste at all. Conclusions: The use of chlorhexidine mouthwash before toothbrushing, and brushing with antimicrobial toothpaste did not show a statistically significant difference in preventing the occurrence of bacteremia (p ＞ 0.05).

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