Microbiology of Odontogenic Bacteremia: beyond Endocarditis

Abstract

SUMMARY The human gingival niche is a unique microbial habitat. In this habitat, biofilm organisms exist in harmony, attached to either enamel or cemental surfaces of the tooth as well as to the crevicular epithelium, subjacent to a rich vascular plexus underneath. Due to this extraordinary anatomical juxtaposition, plaque biofilm bacteria have a ready portal of ingress into the systemic circulation in both health and disease. Yet the frequency, magnitude, and etiology of bacteremias due to oral origin and the consequent end organ infections are not clear and have not recently been evaluated. In this comprehensive review, we address the available literature on triggering events, incidence, and diversity of odontogenic bacteremias. The nature of the infective agents and end organ infections (other than endocarditis) is also described, with an emphasis on the challenge of establishing the link between odontogenic infections and related systemic, focal infections.

Pivotal role of NOD2 in inflammatory processes affecting atherosclerosis and periodontal bone loss

“…Current evidence suggests that oral manipulation procedures are the most common cause of bacterial dissemination in the bloodstream from oral niches (30). Clearly, a higher microbial load would facilitate such dissemination, because it is known that individuals with poor oral hygiene are at a higher risk of developing bacteremia during periodontal surgeries (30).…”

“…Possibly, NOD2 deficiency impairs the host bacterial surveillance involved in maintaining a proper balance between host and pathogens, resulting in a shift of the opportunistic bacterial flora to a more pathogenic form, which in turn, is capable of triggering the immune responses associated with both periodontitis and atherosclerosis (29). Current evidence suggests that oral manipulation procedures are the most common cause of bacterial dissemination in the bloodstream from oral niches (30). Clearly, a higher microbial load would facilitate such dissemination, because it is known that individuals with poor oral hygiene are at a higher risk of developing bacteremia during periodontal surgeries (30).…”

Mechanisms of Periodontitis - Induced Atherosclerosis

“…[73] Chronic bacteremia from periodontitis may be easily happened from the daily activities e.c brushing, chewing, [73] and routine dental procedures like scaling and root planning, or the other treatments like endodontic, orthodontic and dental extraction. [74] Many studies proved that atherosclerosis plaques contained numerous periodontopathogen bacteria, [3,40,76] especially PG. [39,40] Researches have demonstrated that PG induction may invade endothel and may initiate atherosclerosis in pigs.…”

Oral health protocol for liver transplant patients

“…Some risk practices are routinely performed by patients, such as chewing and tooth brushing; others are inherent to dental treatment, such as periodontal procedures, tooth extractions, insertion of orthodontic appliances and endodontic procedures [6,14]. Odontogenic bacteremia is transient, ranging 30-60 minutes, in blood [15][16][17][18][19][20][21]. However, in immunosuppressed patients, microorganisms from the infe-cted site may reach peripheral capillary system and organs, such as heart and lungs, in less than 1 minute after an oral procedure [6].…”