We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Article |

An Analysis of Bacteremias During Dental Extractions A Double-blind, Placebo-Controlled Study of Chlorhexidine

Peter B. Lockhart, DDS
Arch Intern Med. 1996;156(5):513-520. doi:10.1001/archinte.1996.00440050059007.
Text Size: A A A
Published online


Background:  The literature is unclear concerning the nature and incidence of bacteremias from oral surgical procedures, the relationship of these bacteremias to dental disease, and the preventive benefit of antibacterial mouth rinses.

Objective:  To determine the incidence and nature of bacteremias during single-tooth extractions in adults.

Methods:  A double-blind, randomized placebo-controlled study of 70 patients in which the status of dental disease was compared with the incidence and nature of aerobic and anaerobic bacteremias following a singletooth extraction and the antibacterial effect of rinses with chlorhexidine hydrochloride. Multiple indicators of dental disease were evaluated and recorded before the surgical procedure. Timing of the mouth rinses, the steps in the surgical procedure, and the two blood drawings were controlled for.

Results:  Thirty-one (94%) of 34 control patients and 62 (89%) of 70 patients overall had blood cultures positive for organisms at either the l-minute and/or 3-minute mark following the initiation of surgery. The majority of cultures yielded gram-positive cocci. Cultures yielded polymicrobial organisms in 17 patients (24%). Although there was a wide range of severity of odontogenic disease, this did not correlate with results of blood cultures. However, there was a statistically significant difference in the incidence of blood cultures positive for organisms at both shorter (<3 minutes, P=.04) and longer (>6 minutes, P=.04) surgery times. There was no statistically significant difference in either the incidence of blood cultures positive for organisms or in the nature of organisms identified between the chlorhexidine and placebo groups.

Conclusions:  Single-tooth extraction should be expected to cause a bacteremia regardless of the status of the dentition or periodontium. Mouth rinses with chlorhexidine did not significantly alter the number of positive blood cultures or the nature of the organisms at either of the two blood drawings.(Arch Intern Med. 1996;156:513-520)


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

64 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.