Preoperative administration of 0.2% chlorhexidine mouthrinse reduces the risk of bacteraemia associated with intra-alveolar tooth extraction

J Craniomaxillofac Surg. 2014 Dec;42(8):1783-8. doi: 10.1016/j.jcms.2014.06.015. Epub 2014 Jun 14.

Abstract

The aim of the study was to investigate the effect of preoperative 0.2% chlorhexidine mouthwash on the risk of bacteraemia following routine intra-alveolar tooth extraction. The study was a randomized controlled clinical study of 101 subjects who underwent intra-alveolar dental extractions under local anaesthesia. Subjects were randomly assigned to either chlorhexidine or a control group. The chlorhexidine group had 0.2% chlorhexidine mouthwash administered for 1 min before any dental manipulation, and the control group had a mouthrinse of sterile water. Blood samples were collected at baseline, 1 min and 15 min after the dental extractions. Subculture and further identification of the isolated bacteria were performed by conventional microbiological techniques. There was a statistically significant difference in the incidence of bacteraemia between the control group (52.4%) and chlorhexidine group (27.1%) (P = 0.012). Bacteraemia was most frequently detected at 1 min after extraction (33.3%). Of the 30 subjects who had positive blood culture at 1 min, bacteraemia persisted in 8 (26.7%) of the subjects after 15 min. Bacteria isolated included Staphylococcus aureus, Actinomycetes naesulendi, Prevotella species, Streptococcus spp., and Acinetobacter iwoffii. Routine use of 0.20% chlorhexidine mouthwash before dental extraction is recommended to reduce the risk of bacteraemia following tooth extraction.

Keywords: Bacteraemia; Chlorhexidine; Dental extraction.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Acinetobacter / isolation & purification
  • Actinobacteria / isolation & purification
  • Adolescent
  • Adult
  • Aged
  • Anti-Infective Agents, Local / administration & dosage*
  • Bacteremia / microbiology
  • Bacteremia / prevention & control*
  • Chlorhexidine / administration & dosage*
  • Female
  • Follow-Up Studies
  • Humans
  • Lidocaine / administration & dosage
  • Male
  • Middle Aged
  • Molar / surgery
  • Mouthwashes / administration & dosage*
  • Nerve Block / methods
  • Preoperative Care
  • Prevotella / isolation & purification
  • Risk Factors
  • Staphylococcus aureus / isolation & purification
  • Streptococcus / isolation & purification
  • Tooth Extraction / methods*
  • Young Adult

Substances

  • Anti-Infective Agents, Local
  • Mouthwashes
  • Lidocaine
  • Chlorhexidine