Bacteremia in Periodontal Patients
Condition: Gingivitis; Periodontitis
MeSH terms: Gingivitis; Bacteremia; Periodontitis
Study type: Interventional
Phase: Phase 4

Summary: 
      Bacteremia represents the presence of live germs in the blood stream. Patients with gum
      disease show damaged tissues and seem to be more susceptible to bacteremia. In fact, daily
      activities such as mastication can induce bacteremia in these patients. Dental procedures
      related to bleeding also induce bacteremia. However, there are many questions that should be
      clarified. Among them, clinical strategies that are able to reduce the levels of germs in
      blood should be determined. This desirable effect could be particularly important for some
      patients, for example, for those at higher risk for endocarditis. Therefore, this study
      tested if 0.12% chlorhexidine solution used as a single mouth rinse before dental
      instrumentation could reduce the levels of bacteria in the blood. In addition, the occurrence
      and magnitude of bacteremia in patients with gum disease were investigated by two different
      laboratorial techniques. After receiving verbal and written explanations and after signed the
      informed consent form, 80 systemically healthy volunteers diagnosed with gum disease having
      dental plaque and tartar were randomly allocated in one the following groups: a) mouth-rinse
      use and dental instrumentation and b) dental instrumentation with no mouth rinse. In a
      preliminary visit volunteers underwent a complete periodontal examination which included
      clinical measurements (inflammatory and debris accumulation indicators), microbial (tongue
      and dental plaque samples collected with paper points), saliva (to determine volume and
      biological indicators) and gingival crevicular fluid sampling (to monitor gingival
      inflammation profile). In the next visit, dental instrumentation was performed under local
      anesthesia, after the mouth rinse single use in the most diseased periodontal teeth/quadrant.
      Blood samples were collected before any dental procedure, 2 and 6 minutes after dental
      instrumentation. Oral hygiene instructions and periodontal treatment were performed in
      additional visits according to individual needs. Finally, the relation between bacteremia and
      several indicators of periodontal status was investigated.
    


Intervention name(s): Chlorhexidine gluconate mouth rinse; Periodontal instrumentation
Intervention type(s): Drug; Procedure
Intervention description(s): Before local oral anesthesia and periodontal instrumentation individuals performed a single oral rinse (15mL of 0.12% chlorhexidine gluconate for 30 seconds). Debridement procedures were carried out with manual Gracey and McCall curettes and Hirschfield files.; Individuals only received local oral anesthesia before periodontal instrumentation. Debridement procedures were carried out with manual Gracey and McCall curettes and Hirschfield files.
Intervention MeSH terms: Chlorhexidine; Chlorhexidine gluconate
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary purpose: Prevention
Keywords: gingivitis; periodontitis; mouth rinse; bacteremia