Intensity of bacteraemia associated with conservative dental procedures inchildren

Objectives To explore the individual dento-gingival manipulative procedures that together lead to the placement of a restoration and to estimate the a ssociated intensity of bacteraemia. Patients and methods Healthy children receiving dental treatment under gene ral anaesthesia provided blood samples 30 seconds after one of four dento-g ingival manipulative procedures: 1. Placement of rubber dam, 2. Use of the high speed drill, 3, Use of the slow speed drill, and 4. Placement of matri x band and wedge. Blood cultures were processed to give the percentage prev alence of bacteraemia, the intensity of organisms per millilitre of blood a nd the identity of the organisms cultured. Results A total of 257 children were recruited to the study. The percentage positive prevalence of blood cultures was baseline 9.3%, rubber dam placem ent - 31.4%, dow drill - 12.2%, fast drill -4.3%, and matrix band and wedge - 32.1%. The intensity of bacteraemia was baseline - 1.2 cfu, rubber dam p lacement 1,962 cfu, slow drill - 0.3 cfu, fast drill - 1.9 cfu, matrix band and wedge -4.8 cfu. Conclusions These data indicate that dento-gingival manipulative procedures comprising a simple dental restoration can lead to a bacteraemia comparabl e to that from dental extractions. It is suggested that these data may indi cate the need for antibiotic prophylaxis for some aspects of conservative d entistry.