Bacteremia following different oral procedures: Systematic review and meta-analysis.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of randomized and nonrandomized controlled trials
PubMed 36750413 · doi:10.1111/odi.14531
What was done
Eight databases were searched for randomized controlled trials (RCTs) and nonrandomized controlled trials (nRCTs) assessing bacteremia before and after invasive dental procedures or activities of daily living in healthy individuals. Risk of bias was evaluated using RoB 2.0 and ROBINS-I. Primary outcomes were the timing and duration of bacteremia; the secondary outcome was the proportion of individuals with bacteremia within 5 minutes after the procedure compared with baseline. A total of 89 studies (25 RCTs and 64 nRCTs) were analyzed.
What was found
Peak bacteremia occurred within 5 minutes post-procedure and decreased over time. The reported bacteremia incidence was highest for dental extractions (62%–66%), followed by scaling and root planing (36%–44%) and oral health procedures such as dental prophylaxis and probing (27%–28%). Daily activities also produced bacteremia, including flossing and chewing (16%) and toothbrushing (8%–26%).
Why it matters
This review provides quantitative estimates of transient bacteremia across diverse professional dental interventions and everyday oral hygiene practices, contextualizing relative exposure risks.
Limits
The majority of included RCTs had 'some concerns' and nRCTs had a moderate risk of bias. Total participant sample size, confidence intervals, and specific bacterial isolates were not reported in the abstract. The study included only healthy individuals, limiting direct assessment of clinical outcomes in populations susceptible to endocarditis.
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