Bacteremia following intraoral suture removal

Following dental extractions, prophylactic antibiotic protection of patients at high risk of cardiovalvular infection is usually discontinued before suture removal. To determine whether bacteremia is created upon removal of intraoral sutures, twenty healthy patients who required extractions of at least five erupted teeth and placement of several sutures were selected without regard to sex, age, or race. Blood samples were drawn preoperatively, immediately after the extractions, before suture removal, and immediately following removal of the intraoral silk sutures. The samples were cultured in prereduced and aerobic media suitable for quantitative colony counts. Fourteen of 16 patients yielded positive blood cultures following tooth extractions. One of 20 patients yielded a positive blood culture following suture removal. Even though the incidence of bacteremia following intraoral suture removal is relatively low (5%), this study suggests that intraoral suture removal is not a benign procedure for those persons who are considered high-risk cardiac patients.