Bacteremia following subgingival irrigation and scaling and root planing

• Published in: Journal of periodontology (1970) Vol. 62; no. 10; p. 602
• Main Authors: Lofthus, J E, Waki, M Y, Jolkovsky, D L, Otomo-Corgel, J, Newman, M G, Flemmig, T, Nachnani, S
• Format: Journal Article
• Language: English
• Published: United States 01.10.1991
• Subjects: Adult; Aged; Aged, 80 and over; Bacteremia - etiology; Bacteremia - prevention & control; Bacteria - isolation & purification; Chlorhexidine - administration & dosage; Chlorhexidine - therapeutic use; Dental Plaque - therapy; Dental Scaling - adverse effects; Humans; Incidence; Middle Aged; Periodontal Pocket - therapy; Root Planing - adverse effects; Therapeutic Irrigation - adverse effects; Water
• ISSN: 0022-3492
• DOI: 10.1902/jop.1991.62.10.602

The purpose of this study was to determine the incidence of bacteremia after a single professional subgingival irrigation with a 0.12% chlorhexidine gluconate mouthrinse (CHX) as well as after a subsequent scaling and root planing (S/RP) during the same visit. Thirty subjects each with at least 1 site that probed 4 mm or more and bled on probing were randomly assigned to the following groups: 1) irrigation with 0.12% CHX; 2) irrigation with sterile water; and 3) non-irrigated controls. To begin the study blood was drawn just before and 2 minutes after irrigation. Thirty minutes later, blood was drawn again just before and 2 minutes after S/RP at the same site. Specimens were cultured for anaerobic and aerobic microorganisms using standard cultural techniques. Eighteen blood cultures from 15 subjects yielded positive cultures resulting in 23 isolates. Gram-positive rods comprised 34.8% of the total isolates; Gram-positive cocci 34.8%, Gram-negative rods 21.7%, and Gram-negative cocci 8.7%. In the CHX group, bacteremia was detected in 5 subjects after irrigation and in 2 other subjects after S/RP. In the water group, bacteremia was detected in one subject after irrigation and in 4 subjects after S/RP. The control group had 3 bacteremias after S/RP. There was no significant difference between the incidence of bacteremia associated with irrigation by CHX or sterile water (P = 0.141). There was also no significant difference in the incidence of bacteremia after S/RP between the CHX and sterile water irrigation groups and in patients who did not receive irrigation (control group) (P = 0.88).