Bacteremia following tooth extraction--effect of various factors
Rahn, R.; Shah, P.M.; Schäfer, V.; Frenkel, G.; Halbherr, K.
Zwr 95(8): 822-826
1986
ISSN/ISBN: 0044-166X PMID: 3466481 Document Number: 267984
Blood samples were taken before and after anesthesia and after the end of surgery in 120 patients who had teeth extracted for various reasons. The blood was studied for microbial growth in aerobic and anaerobic cultures. The results of blood cultures taken after tooth extraction were correlated to age, sex, dentition, oral hygiene and periodontal disease of the patient as well as to the localization and number of teeth extracted and the reason for tooth extraction. All of the blood samples taken before anesthesia were sterile; microbes were found in 11.7% of the samples taken after anesthesia and in 58.3% of the samples taken after tooth extraction. Bacteriological studies revealed predominantly streptococci of viridans type followed by many aerobic and anaerobic organisms. A higher percentage of positive cultures was found in patients with poor oral hygiene and periodontal disease. An elevated microbial count in the wound area and an increased blood flow through the periodontal tissue in inflammatory diseases of the periodontium were reasons for this. A high percentage of positive cultures was also found in older patients, patients with partial dentition and in tooth extraction due to deeply destroyed crowns. These factors were generally combined with poor oral hygiene which explained the increased frequency of bacteremia. The frequency of bacteremia also increased with the number of teeth removed in one sitting, since the probability of passage of microbes into the bloodstream increases with the size of the wound surface.