Generally, only patients who have certain heart conditions or an artificial joint are considered at a high risk of developing the heart infection called infective endocarditis, and are prescribed preventive antibiotics before a dental procedure.
Researchers studied 290 dental patients to see if bacteria entered their bloodstreams when brushing their teeth having a single tooth extracted after taking a preventive antibiotic and having a tooth extracted after taking a placebo.
Scientists found bacteremia more often in the groups who had extractions, but tooth brushing also resulted in bacteria entering the bloodstream, suggesting that routine activities like tooth brushing or even chewing food could result in bacteria entering the bloodstream hundreds of times a year.
“While the likelihood of bacteremia is lower with brushing, these routine daily activities likely pose a greater risk for IE simply due to frequency: that is, bacteremia from brushing twice a day for 365 days a year versus once or twice a year for dental office visits involving teeth cleaning, fillings and other procedures,” said Dr. Peter Lockhart, one of the study’s authors. “For people who are not at risk for infections such as IE, the short-term bacteremia is nothing to worry about.”
The study showed that 23 percent of samples from the tooth-brushing group had bacteria related to IE, as did 33 percent of the extraction with antibiotics group and 60 percent of the extraction with placebo group. The highest incidence occurred within five minutes of the procedures.
Patients who don’t use good oral hygiene have more oral disease like gum disease and decay, Dr. Lockhart added, “that lead to chronic and acute infections such as abscesses. It’s that sort of thing that puts you at risk for frequent bacteremia and presumably endocarditis if you have a heart or other medical condition that puts you at risk.”
The authors say that avoiding dental disease by using a good dental hygiene routine may reduce an at-risk patient’s chances for developing infective endocarditis.
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