Are Dental Procedures Associated With Pyogenic Vertebral Osteomyelitis?

Area of Science:

• Infectious Diseases
• Orthopedics
• Dental Medicine

Background:

• Dental procedures may cause bacteremia, a potential risk factor for pyogenic vertebral osteomyelitis (PVO).
• Limited data exist on the association between dental procedures and PVO risk.

Purpose of the Study:

• To determine if dental procedures increase PVO risk after controlling for confounding variables.
• To assess the effectiveness of antibiotic prophylaxis in reducing PVO risk post-dental procedures.

Main Methods:

• A case-crossover study utilized a Japanese claims database (April 2014-September 2021).
• 3599 patients hospitalized for PVO were analyzed, comparing dental procedure frequency in a 4-week hazard period versus control periods (9-12 and 17-20 weeks prior).
• Conditional logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (CI).

Main Results:

• Dental procedures were not associated with an increased risk of PVO (OR 0.81 [95% CI 0.72 to 0.92]).
• Antibiotic prophylaxis did not reduce the risk of PVO after dental procedures (OR 1.11 [95% CI 0.93 to 1.32] with prophylaxis; OR 0.72 [95% CI 0.63 to 0.83] without).
• Sensitivity analyses confirmed these findings.

Conclusions:

• Dental procedures are not linked to a higher risk of subsequent PVO.
• The effectiveness of antibiotic prophylaxis in preventing PVO post-dental procedures was not demonstrated.
• Findings suggest reconsidering antibiotic prophylaxis indications and emphasize the importance of oral hygiene for PVO prevention.