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11. Bacteremia following different oral procedures: Systematic review and meta‐analysis.

Author

Martins, Carolina C., Lockhart, Peter B., Firmino, Ramon T., Kilmartin, Catherine, Cahill, Thomas J., Dayer, Mark, Occhi‐Alexandre, Ingrid G. P., Lai, Honghao, Ge, Long, and Thornhill, Martin H.

Subjects
*ORAL surgery, *MEDICAL information storage & retrieval systems, *DENTAL scaling, *DISEASE duration, *RESEARCH funding, *BACTEREMIA, *META-analysis, *ORAL hygiene, *SYSTEMATIC reviews, *MEDLINE, *MEDICAL databases, *TOOTH root planing, *MASTICATION, *DENTAL extraction, *TOOTH care & hygiene, *ACTIVITIES of daily living, *DENTAL prophylaxis
Abstract

To evaluate the timing, duration and incidence of bacteremia following invasive dental procedures (IDPs) or activities of daily living (ADL). Eight databases were searched for randomized (RCTs) and nonrandomized controlled trials (nRCTs) evaluating bacteremia before and after IDPs or ADL in healthy individuals. The risk of bias was assessed by RoB 2.0 and ROBINS‐I. For the meta‐analysis, the primary outcomes were the timing and duration of bacteremia. The secondary outcome was the incidence of bacteremia, measuring the proportion of patients with bacteremia within 5 min after the end of the procedure compared with baseline. We included 64 nRCTs and 25 RCTs. Peak bacteremia occurred within 5 min after the procedure and then decreased over time. Dental extractions showed the highest incidence of bacteremia (62%–66%), followed by scaling and root planing (SRP) (44%–36%) and oral health procedures (OHP) (e.g., dental prophylaxis and dental probing without SRP) (27%–28%). Other ADL (flossing and chewing) (16%) and toothbrushing (8%–26%) resulted in bacteremia as well. The majority of studies had some concerns RCTs or moderate risk of bias nRCTs. Dental extractions, SRP and OHP, are associated with the highest frequency of bacteremia. Toothbrushing, flossing, and chewing also caused bacteremia in lower frequency. [ABSTRACT FROM AUTHOR]

Published
2024
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12. Endocarditis, invasive dental procedures, and antibiotic prophylaxis efficacy in US Medicaid patients.

Author

Thornhill, Martin H., Gibson, Teresa B., Yoon, Frank, Dayer, Mark J., Prendergast, Bernard D., Lockhart, Peter B., O'Gara, Patrick T., and Baddour, Larry M.

Subjects
ENDOCARDITIS prevention, ORAL surgery, RISK assessment, RESEARCH funding, ENDOCARDITIS, DESCRIPTIVE statistics, OPERATIVE surgery, LONGITUDINAL method, CROSSOVER trials, ODDS ratio, DRUG efficacy, ANTIBIOTIC prophylaxis, MEDICAID, CONFIDENCE intervals, DENTAL extraction, HEALTH equity, DISEASE risk factors
Abstract

Objective: Antibiotic prophylaxis is recommended before invasive dental procedures to prevent endocarditis in those at high risk, but supporting data are sparse. We therefore investigated any association between invasive dental procedures and endocarditis, and any antibiotic prophylaxis effect on endocarditis incidence. Subjects and Methods: Cohort and case‐crossover studies were performed on 1,678,190 Medicaid patients with linked medical, dental, and prescription data. Results: The cohort study identified increased endocarditis incidence within 30 days of invasive dental procedures in those at high risk, particularly after extractions (OR 14.17, 95% CI 5.40–52.11, p < 0.0001) or oral surgery (OR 29.98, 95% CI 9.62–119.34, p < 0.0001). Furthermore, antibiotic prophylaxis significantly reduced endocarditis incidence following invasive dental procedures (OR 0.20, 95% CI 0.06–0.53, p < 0.0001). Case‐crossover analysis confirmed the association between invasive dental procedures and endocarditis in those at high risk, particularly following extractions (OR 3.74, 95% CI 2.65–5.27, p < 0.005) and oral surgery (OR 10.66, 95% CI 5.18–21.92, p < 0.0001). The number of invasive procedures, extractions, or surgical procedures needing antibiotic prophylaxis to prevent one endocarditis case was 244, 143 and 71, respectively. Conclusions: Invasive dental procedures (particularly extractions and oral surgery) were significantly associated with endocarditis in high‐risk individuals, but AP significantly reduced endocarditis incidence following these procedures, thereby supporting current guideline recommendations. [ABSTRACT FROM AUTHOR]

Published
2024
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14. World Workshop on Oral Medicine VIII: Dentists’ compliance with infective endocarditis prophylaxis guidelines for patients with high-risk cardiac conditions: a systematic review

Author

Diz Dios, Pedro, primary, Monteiro, Luis, additional, Pimolbutr, Kununya, additional, Gobbo, Margherita, additional, France, Katherine, additional, Bindakhil, Mohammed, additional, Holmes, Haly, additional, Sperotto, Francesca, additional, Graham, Laurel, additional, Turati, Federica, additional, Salvatori, Andrea, additional, Hong, Catherine, additional, Sollecito, Thomas P., additional, Lodi, Giovanni, additional, Thornhill, Martin H., additional, Lockhart, Peter B., additional, and Edefonti, Valeria, additional

Published
2023
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18. Reply

Author

Thornhill, Martin H., primary, Dayer, Mark J., additional, Lockhart, Peter B., additional, O’Gara, Patrick T., additional, and Baddour, Larry M., additional

Published
2023
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25. Assessment of Infectious Diseases Risks From Dental Aerosols in Real-World Settings

Author

Choudhary, Shruti, primary, Bach, Tracey, additional, Wallace, Meghan A, additional, Stoeckel, Daniel C, additional, Thornhill, Martin H, additional, Lockhart, Peter B, additional, Kwon, Jennie H, additional, Liang, Stephen Y, additional, Burnham, Carey-Ann D, additional, Biswas, Pratim, additional, Steinkamp, Heidi M, additional, and Durkin, Michael J, additional

Published
2022
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35. IMPACT OF ANTIBIOTIC PROPHYLAXIS ON THE INCIDENCE OF INFECTIVE ENDOCARDITIS FOLLOWING INVASIVE DENTAL PROCEDURES: A SYSTEMATIC REVIEW AND META-ANALYSIS. A REPORT FROM THE WORLD WORKSHOP OF ORAL MEDICINE VIII

Author

Sperotto, Francesca, France, Katherine, Turati, Federica, Gobbo, Margherita, Bindakhil, Mohammed, Pimolbutr, Kununya, Holmes, Haly Karen, Monteiro, Luis, Salvatori, Andrea, Graham, Laurel, Hong, Catherine, Sollecito, Thomas P., Lodi, Giovanni, Lockhart, Peter B., Thornhill, Martin, Dios, Pedro Diz, and Edefonti, Valeria

Published
2024
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41. Oral microbiomes of patients with infective endocarditis (IE): a comparative pilot study of IE patients, patients at risk for IE and healthy controls.

Author

Mougeot, Jean-Luc C., Beckman, Micaela, Paster, Bruce J., Lockhart, Peter B., and Mougeot, Farah Bahrani

Subjects
INFECTIVE endocarditis, STREPTOCOCCUS sanguis, STREPTOCOCCUS mutans, RARE diseases, PILOT projects, STAPHYLOCOCCUS aureus, MILK microbiology
Abstract

Background: Infective endocarditis (IE) is an uncommon disease with high morbidity and mortality rates, which often develops from oral bacterial species entering circulation. Objective: We compared oral microbiome profiles of three groups: IE patients (N 9 patients; n = 27 samples), disease controls at risk for IE (N = 28; n = 84), and healthy controls (N = 37; n = 111). Bacterial species in IE patients’ blood cultures were identified for comparison with matched oral samples. Design: Oral microbiome profiles were obtained from buccal mucosa, saliva, and tongue samples for all three groups and from sub- and supra-gingival plaque samples of the IE group (N = 9; n = 16) and disease controls (N = 28; n = 54). Alpha- and beta-diversities were determined based on relative abundance data. Discriminative species were identified by LEfSe, post hoc Mann-Whitney, and ROC analyses. Identity of the bacterial species in IE patients’ blood cultures was confirmed by 16S-rRNA gene Sanger sequencing. Results: Alpha- and beta-diversities differed between groups. Discriminative IE-associated species were identified, e.g. Haemophilus parainfluenzae and Streptococcus sanguinis. Two blood isolates were Staphylococcus aureus, also identified in one matched saliva sample. Streptococcus mutans was present in one patient’s plaque samples and blood culture. Conclusions: Oral microbiomes of IE, non-IE disease controls, and healthy controls differed significantly. A better understanding of IE-related bacterial-host interactions is warranted. [ABSTRACT FROM AUTHOR]

Published
2023
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42. Motivational Factors in the Choice of Postdoctoral General Dentistry Programs.

Author

Lockhart, Peter B.

Abstract

A survey of 599 dental students in a postdoctoral school matching program identified factors in choice of postdoctoral program. Factors affecting program choice included gender, program type, location, salary and benefits, and program philosophy and faculty. Most applicants perceived a need for more training in general clinical dentistry, medical principles, and managing compromised patients. (Author/MSE)

Published
1997

46. Adapted from: Prevention of Viridans Group Streptococcal Infective Endocarditis

Author

Wilson, Walter R., primary, Gewitz, Michael, additional, Lockhart, Peter B., additional, Bolger, Ann F., additional, DeSimone, Daniel C., additional, Kazi, Dhruv S., additional, Couper, David J., additional, Beaton, Andrea, additional, Kilmartin, Catherine, additional, Miro, Jose M., additional, Sable, Craig, additional, Jackson, Mary Anne, additional, and Baddour, Larry M., additional

Published
2021
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47. Behavioral Medicine Training in Postdoctoral Dental Education.

Author

Lockhart, Peter B.

Abstract

Carolinas Medical Center (North Carolina) initiated a behavioral training program for general practice dental residents to develop skills in handling patient anxiety/stress, obesity, and depression. The program includes monthly seminars, a clinical rotation in behavioral medicine with additional related seminars, and a month-long clinical rotation in family practice medicine. (MSE)

Published
1992

50. Infective Endocarditis in Adults: Diagnosis, Antimicrobial Therapy, and Management of Complications: A Scientific Statement for Healthcare Professionals From the American Heart Association

Author

Baddour, Larry M., Wilson, Walter R., Bayer, Arnold S., Fowler, Vance G., Jr, Tleyjeh, Imad M., Rybak, Michael J., Barsic, Bruno, Lockhart, Peter B., Gewitz, Michael H., Levison, Matthew E., Bolger, Ann F., Steckelberg, James M., Baltimore, Robert S., Fink, Anne M., O‘Gara, Patrick, and Taubert, Kathryn A.

Published
2015
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