Poor oral hygiene as a risk factor for infective endocarditis–related bacteremia
Open accessAbstract
Background Infective endocarditis (IE) often is caused by bacteria that colonize teeth. The authors conducted a study to determine if poor oral hygiene or dental disease are risk factors for developing bacteremia after toothbrushing or single-tooth extraction. Methods One hundred ninety-four participants in a study were in either a toothbrushing group or a single-tooth extraction with placebo group. The authors assessed the participants’ oral hygiene, gingivitis and periodontitis statuses. They assayed blood samples obtained before, during and after the toothbrushing or extraction interventions for IE-associated bacteria. Results The authors found that oral hygiene and gingival disease indexes were associated significantly with IE-related bacteremia after toothbrushing. Participants with mean plaque and calculus scores of 2 or greater were at a 3.78- and 4.43-fold increased risk of developing bacteremia, respectively. The presence of generalized bleeding after toothbrushing was associated with an almost eightfold increase in risk of developing bacteremia. There was no significant association between any of the measures of periodontal disease and the incidence of bacteremia after toothbrushing. The oral hygiene or disease status of a tooth was not significantly associated with bacteremia after its extraction. Conclusion Bacteremia after toothbrushing is associated with poor oral hygiene and gingival bleeding after toothbrushing. Clinical Implications Improvements in oral hygiene may reduce the risk of developing IE.
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A large, prospective study demonstrated a strong association between 3 indexes of oral hygiene and gingival disease and the incidence of bacteremia from IE-related species.
“A large, prospective study demonstrated a strong association between 3 indexes of oral hygiene and gingival disease and the incidence of bacteremia from IE-related species.327”
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Self-citation
- Authors
- Lockhart, P. B., Brennan, M. T., Thornhill, M., Michalowicz, B. S., Noll, J., Bahrani-Mougeot, F. K., & Sasser, H. C.
- Affiliations
- Carolinas Medical Center (US)
- University of Sheffield (GB)
- University of Minnesota (US)
- Corresponding author
- Lockhart, Peter B.
- Venue
- The Journal of the American Dental Association
- Publisher
- Elsevier BV
- Published
- 2009-10
- Volume
- 140
- Issue
- 10
- Pages
- 1238-1244
- ISSN
- 0002-8177 (ISSN-L)
- PMC
- PMC2770162
- OpenAlex
- W1983444348
- Semantic Scholar
- 5f39afbd2b8096a330e923a588afbdc835a8ee76
- Cited by
- 504
- References
- 22
- Citations by year
- 2026: 22 · 2025: 31 · 2024: 38 · 2023: 34 · 2022: 47 · 2021: 62 · 2020: 44 · 2019: 28 · 2018: 18 · 2017: 33 · 2016: 22 · 2015: 26 · 2014: 17 · 2013: 20 · 2012: 28
- FWCI
- 13.87
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The Journal of the American Dental Association (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Dental and Craniofacial Research (R01 DE13559-01, R01DE013559)
- Topics
- Health Sciences › Medicine › Epidemiology › Infective Endocarditis Diagnosis and Management
- Health Sciences › Dentistry › Periodontics › Oral microbiology and periodontitis research
- Health Sciences › Dentistry › Periodontics › Dental Health and Care Utilization
- Keywords
- infective endocarditis, bacteremia, oral hygiene, gingivitis, periodontitis, toothbrushing, tooth extraction, dental plaque, dental calculus, gingival bleeding, risk factors, oral bacteria
- MeSH terms
- Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Dental Calculus, Dental Plaque, Dental Plaque Index, Double-Blind Method, Endocarditis, Bacterial, Female, Gingivitis, Humans, Male, Middle Aged, Oral Hygiene, Oral Hygiene Index, Risk Factors, Toothbrushing, United States, Bacteremia, Antibiotic Prophylaxis, Viridans Streptococci, Young Adult
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