INTRODUCTION:

Dental procedures are the commonly undergone treatment by most of the individuals. Unfortunately, dental treatment has been regarded as a major cause of infective endocarditis, mainly because of the high frequency of bacteremia after various oral procedures and high recovery rate of viridans streptococci from the blood of patients with infective endocarditis (1-3). Bacteria may invade the bloodstream after a variety of clinical procedures (4). There is a currently significant interest in the possibility that bacteremia with oral bacteria may also play role in pathogenesis of atherosclerosis (5).

Bacteremia frequently occurs after treatment procedures such as extractions, [6] scaling, [7] scaling and root planing, [8] periodontal probing, [9] periodontal surgery, [10] suture removal, [11] orthodontic treatment, [12] restorative dentistry, [13] non-surgical root canal treatment.[14] However, not only professional treatment, but also chewing, [15] subgingival irrigation, [16] and oral hygiene procedures such as tooth brushing [17] and flossing [18] have been reported to give rise to bacteremia. Scaling is a simple dental procedure which is very commony done. Scaling and root planing, otherwise known as conventional periodontal therapy, non-surgical periodontal therapy, or deep cleaning, is the process of removing or eliminating the etiologic agents – dental plaque, its products, and calculus – which cause inflammation, (19) thus helping to establish a periodontium that is free of disease. This study is done to know the effect of oral health in systemic health, occurance of bacteremia after scaling.

METHODOLOGY:

Patients with chronic periodontitis are selected for this research. 10 such patients are choosen without any systemic disorder. These patients where completely informed about the research and the patient’s consern was got. Blood sample of 5 ml was collected in a duration of 20 days, within 30 minutes of scaling. Prior to the collection of blood, the site was disinfected. The sample collected was inoculated in LQ012 using a sterile needle. The blood culture bottles where incbated at 37 C. samples with positive result where further analysed. They where inoculated in nutrient agar and the plates where incubated for 12 hours. Samples where collected and smear was made. These smears where done gram’s staining and viewed under compound microscope to identify the bacteria.

RESULT:

Among the 10 blood samples that where collected from patients with chronic periodontitis 3 showed positive result. The positive result was seen within 3 days of inoculation. Bacteria from the medias where sub cultured in nutrient agar and colonies where allowed to develop. Gram’s stained smear showed the presence of streptococcus, Sthaphylococcus and micrococcus.

PATIENT	RESULT
1	NO GROWTH
2	NO GROWTH
3	GROWTH AFTER 3 DAYS
4	NO GROWTH
5	NO GROWTH
6	GROWTH AFTER 3 DAYS
7	GROWTH AFTER 3 DAYS
8	NO GROWTH
9	NO GROWTH
10	NO GROWTH

DISCUSSION:

In this study among the 10 patients 30% of them have shown bacteremia after scaling, which correlates with other research done on frequency of bacteremia in patients with chronic periodontitis (20). The bacterial species that were detected were coagulase negative staphylococcus, alpha haemolytic streptococcus and micrococcus. These are the common facultative anaerobes present in the oral cavity as commensals . These bacteria are frequently seen in association with bacteremia in patients with periodontitis (21). They are responsible for infective endocarditis, renal abscess and colanisation of prosthesis in the circulation. These patients who have shown positive blood culture did not have any sign of bacteremia prior to scaling.

CONCLUSION:

Occurrence of bacteremia after scaling in 30% of the cases is significant and it should be taken care. An antibiotic cover is mandatory even before scaling is done as done for extraction.

REFERENCE:

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19. Grant, DS, Stern IB Periodontics, 6th Edition, CV Mosby and Co. St. Louis 1988

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21. Bacteraemia following periodontal procedures Authors Denis F. Kinane, Marcello P. Riggio, Katie F. Walker, Duncan MacKenzie, Barbara Shearer

Received on 16.06.2015 Modified on 24.06.2015

Research J. Pharm. and Tech. 8(11): Nov., 2015; Page 1605-1606

DOI: 10.5958/0974-360X.2015.00285.1