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Updated: Jul 4, 2026
06:09
Rapid Isolation of Single Cells from Mouse and Human Teeth
Published on: October 28, 2021
Bacteremia associated with toothbrushing and dental extraction
Peter B Lockhart1, Michael T Brennan, Howell C Sasser
1Department of Oral Medicine, Carolinas Medical Center, PO Box 32861, Charlotte, NC 28232-2861, USA. Peter.Lockhart@carolinashealthcare.org
Circulation
|June 11, 2008
Summary
Toothbrushing may pose a greater risk for infective endocarditis (IE) bacteremia than single-tooth extraction, despite amoxicillin prophylaxis effectiveness. Daily oral hygiene practices warrant careful consideration for IE prevention strategies.
Area of Science:
- Oral Microbiology
- Infectious Diseases
- Cardiology
Background:
- Current infective endocarditis (IE) prophylaxis guidelines consider bacteremia from dental procedures.
- Toothbrushing, a frequent oral hygiene activity, may contribute significantly to IE risk.
Purpose of the Study:
- To compare bacteremia incidence, duration, nature, and magnitude between toothbrushing and single-tooth extraction.
- To evaluate the efficacy of amoxicillin prophylaxis in single-tooth extraction procedures.
Main Methods:
- A double-blind, placebo-controlled study involving 290 subjects.
- Randomization into toothbrushing, extraction with amoxicillin, or extraction with placebo groups.
- Blood cultures collected at 6 time points to identify IE-related bacteria.
Main Results:
- Cumulative incidence of IE-related bacteremia was 23% (toothbrushing), 33% (extraction-amoxicillin), and 60% (extraction-placebo).
- Significant differences in bacteremia were observed among groups post-intervention.
- Amoxicillin significantly reduced positive bacterial cultures (P<0.0001).
Conclusions:
- Toothbrushing may represent a greater bacteremia threat for individuals at risk for IE compared to single-tooth extraction.
- Amoxicillin demonstrates significant impact in reducing bacteremia from dental extractions.
- Frequent oral hygiene practices require careful assessment for IE prevention.
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