Prevalence, intensity and identity of bacteraemia following conservative dental procedures in children.

Introduction: The aim of this study was to investigate the prevalence, intensity and microbial identity of bacteraemia following conservative dental procedures. The procedures were placement of rubber dam, use of the fast drill, use of the slow drill and placement of a matrix band and wedge.

Method: Two hundred and five children and adolescents undergoing general anaesthesia for dental treatment at the Eastman Dental Hospital were recruited. Each subject was randomly allocated to one of the procedure groups. A baseline blood sample was taken before any dental treatment was carried out. A second blood sample was taken 30 s after a single conservative procedure. The blood samples were processed using lysis filtration. All bacterial isolates were identified using comparative 16 S ribosomal RNA gene sequencing. Oral Streptococcus spp. and coagulase-negative Staphylococcus spp. were further identified by comparative sodA gene sequencing.

Results: The prevalence of bacteraemia was significantly greater following placement of rubber dam (P = 0.01) and placement of matrix band and wedge, compared with baseline. The intensity of bacteraemia was significantly greater following placement of rubber dam (P = 0.001) and placement of matrix band and wedge (P = 0.0001). The most frequently isolated bacteria were Streptococcus spp. (56%), Actinomyces spp. (15%) and coagulase-negative Staphylococcus spp. (15%).

Conclusion: Conservative dental procedures are a significant cause of bacteraemia.