ResearchThe impact of oral disease and nonsurgical treatment on bacteremia in children
Section snippets
SUBJECTS, MATERIALS AND METHODS
We enrolled 100 children who required dental treatment in an OR setting owing to uncooperative behavior, young age or the extent of treatment needs. We obtained consent from each child's parent or legal guardian as approved by the institutional review board at Carolinas Medical Center, Charlotte, N.C. We randomized the subjects using a computer-generated random number scheme, and used identical-appearing syringes to administer the placebo or the amoxicillin. All of the investigators were
RESULTS
We enrolled 100 children (age range, 1–8 years) in the study. We randomized the subjects to receive a placebo (51) or amoxicillin (49). We did not collect draw 2 from one subject, and we did not collect draw 3 from six subjects. We dropped these subjects from the data analyses.
The incidence of bacteremia from draw 2 was 20 percent in the placebo group and 6 percent in the amoxicillin group (P = .07). The incidence of bacteremia from draw 3 was 16 percent in the placebo group and zero percent in
DISCUSSION
A variety of dental procedures have been associated with bacteremia in children, but few studies have assessed bacteremia after nonsurgical procedures. Incidence rates after oral prophylaxis in children range from 0 to 40 percent,15, 17, 18 while studies in adults have shown incidence rates of 15 to 61 percent.21, 22 Minimal information is available for incidence rates associated with other types of dental procedures in children. One study reported a higher incidence of bacteremia with rubber
CONCLUSIONS
Few studies have addressed the role of dental disease and dental procedures in children. Our study suggests that gingival disease has an effect on bacteremia after dental restorations and prophylaxis. Although antibiotics have an impact, they do not eliminate bacteremia.
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2010, Journal of EndodonticsCitation Excerpt :However, it is encouraging to note that “preoperative prophylaxis has reduced deep infections occurring in the immediate postoperative period in the past 20 years” (1–5). In a placebo-controlled trial, Brennan et al (15) reported that amoxicillin given before nonsurgical dental procedures reduced the incidence of bacteremia from 20% in the placebo group to 6% in those given amoxicillin. Uçkay et al (12) provided a critical review of the current evidence and reported that although antibiotic prophylaxis reduces bacteremia, it does not eliminate it.
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The authors would like to acknowledge Drs. Margaret Lochary, Kelly Zukaitis and Carlton V. Winter for their participation in this study. In addition, the authors thank David Weinrib, MD, and David Rupar, MD, for their help with the microbiology data, and William T. Williams, MD, for his instrumental and longstanding support of this effort.
- 1
Dr. Brennan is the oral medicine residency director, Department of Oral Medicine, Carolinas Medical Center, P.O. Box 32861, Charlotte, N.C. 28232
- 2
Ms. Kent is the clinical coordinator, Department of Oral Medicine, Carolinas Medical Center, Charlotte, N.C.
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Dr. Fox is the clinical research director, Department of Oral Medicine, Carolinas Medical Center, Charlotte, N.C.
- 4
Dr. Norton is the director of biostatistics, Department of Biostatistics, Carolinas Medical Center, Charlotte, N.C.
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Dr. Lockhart is chairman, Department of Oral Medicine, Carolinas Medical Center, Charlotte, N.C.