OBJECTIVES: To explore the individual dento-gingival manipulative procedures that together lead to the placement of a restoration and to estimate the associated intensity of bacteraemia. PATIENTS AND METHODS: Healthy children receiving dental treatment under general anaesthesia provided blood samples 30 seconds after one of four dento-gingival 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 matrix band and wedge. Blood cultures were processed to give the percentage prevalence of bacteraemia, the intensity of organisms per millilitre of blood and 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 placement--31.4%, slow 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 placement--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 comparable to that from dental extractions. It is suggested that these data may indicate the need for antibiotic prophylaxis for some aspects of conservative dentistry.
OBJECTIVES: To explore the individual dento-gingival manipulative procedures that together lead to the placement of a restoration and to estimate the associated intensity of bacteraemia. PATIENTS AND METHODS: Healthy children receiving dental treatment under general anaesthesia provided blood samples 30 seconds after one of four dento-gingival 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 matrix band and wedge. Blood cultures were processed to give the percentage prevalence of bacteraemia, the intensity of organisms per millilitre of blood and 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 placement--31.4%, slow 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 placement--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 comparable to that from dental extractions. It is suggested that these data may indicate the need for antibiotic prophylaxis for some aspects of conservative dentistry.