Investigation of bacteremia after toothbrushing in orthodontic patients

Emad Ahmad Hussein; Ahu Acar; Alev Aksoy Dogan; Tanju Kadir; Seniz Caldemir; Nejat Erverdi

doi:10.4041/kjod.2009.39.3.177

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Hussein, Acar, Dogan, Kadir, Caldemir, and Erverdi: Investigation of bacteremia after toothbrushing in orthodontic patients

Original Article

Korean J Orthod 2009;39(3):177-184.

Published online: 21 January 2009

DOI: https://doi.org/10.4041/kjod.2009.39.3.177

Investigation of bacteremia after toothbrushing in orthodontic patients

Emad Ahmad Hussein^a, Ahu Acar^b, Alev Aksoy Dogan^c, Tanju Kadir^d, Seniz Caldemir^e, Nejat Erverdi^f

^aAssistant Professor, Chairman, Department of Orthodontics, Arab American University, Zababda Jenin, Palestine, Palestine Territories, Istanbul, Turkey.

^bAssociate Professor, Department of Orthodontics, Faculty of Dentistry, Marmara University, Istanbul, Turkey.

^eFormer Graduate Student, PhD, Department of Orthodontics, Faculty of Dentistry, Marmara University, Istanbul, Turkey.

^fProfessor, Department of Orthodontics, Faculty of Dentistry, Marmara University, Istanbul, Turkey.

^cAssistant Professor, Department of Orthodontics, Faculty of Dentistry, Süleyman Demirel University, Isparta, Turkey.

^dAssociate Professor, Department of Microbiology, Faculty of Dentistry, Marmara University, Istanbul, Turkey.

Corresponding author: Alev Aksoy Dogan. Department of Orthodontics, Faculty of Dentistry, Süleyman Demirel University, Isparta, Turkey. ＋90 246 211 33 74; e-mail, alevak2000@yahoo.com

Received 11 November 200827 April 2009 Accepted 2 May 2009

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective

The aim of this study was to investigate the occurrence rate of bacteremia following toothbrushing with toothpastes composed of several antibacterial agents and compare the results with the conventional oral hygiene maintaining methods in orthodontic patients.

Methods

This clinical study included 100 adult orthodontic patients who were divided into 4 groups. Each group comprised of 25 patients, wearing fixed orthodontic appliances. In the first group, bacteremia was assessed after toothbrushing without using any toothpaste. In the second group, a 0.2% chlorhexidine gluconate mouthrinse was used before brushing with no toothpaste. In the third group, subjects brushed with a commonly used toothpaste which did not include an additional antimicrobial agent. The fourth experimental group used toothpaste which included tea tree oil, clove oil, peppermint oil and bisabolol as antimicrobial elements. Pre- and post-brushing blood samples were obtained using a strict aseptic technique. All samples were microbiologically evaluated using blood culture bottles.

Results

Toothbrushing in orthodontic patients yielded to an increase in the occurrence rate of bacteremia when using normal toothpaste or no toothpaste at all.

Conclusions

The use of chlorhexidine mouthwash before toothbrushing, and brushing with antimicrobial toothpaste did not show a statistically significant difference in preventing the occurrence of bacteremia (p ＞ 0.05).

Keywords: Bacteremia, Toothbrushing, Chlorhexidine gluconate, Antibacterial agents

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Table 1.

Positive blood culture results obtained from the four groups

Group	Control (n=25)	Chlorhexidine (n=25)	Ipana (n=25)	Onedroponly (n=25)
Pre-brushing	-	-	-	-
Post-brushing	4(16%)	1(4%)	2(8%)	0(0%)

Table 2.

Microbiologic analysis

Group	Control	Chlorhexidine	Ipana	One drop only
Pre-brushing	-	-	-	-
Post-brushing	S. salivarius S. mitis
	Actinomyces sp. S. sanguinis	S. sanguis	S. salivarius	-

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