Mouthwash may reduce bacteremia after wisdom tooth extraction

By Sarah Guy, medwireNews Reporter

Use of a povidone iodine (PI)- or chlorhexidine (CHX)-based mouthwash immediately before third molar extraction reduces bacteria levels in patients' blood after the procedure, Turkish study findings reveal.

Although bacteria levels were not reduced significantly further after PI or CHX than after rinsing with a saline solution, it does seem that PI worked better than CHX in preventing bacteremia, say the researchers.

Cagri Delilbasi (Instanbul Medipol University) and co-workers randomly assigned 34 individuals aged a mean 27 years who were undergoing third molar - wisdom tooth - extraction to rinse their mouths with 15 mL 7.5% PI mouthwash (n=12), 15 mL 0.2% CHX (n=12), or 0.9% sterile saline solution (n=10) for 1 minute following a pre-procedure blood draw.

The researchers report no significant differences in mouthwash designation according to age, gender, mean plaque index, gingival bleeding index, and duration of procedure.

Participants provided two further blood samples for analysis 1 minute and 15 minutes after their tooth was removed.

Bacteremia was present at any time point in 33% of the participants in the PI group, 33% of those in the CHX group, and 50% of those in the control group, report Delilbasi et al in the Australian Dental Journal. These results were not significantly different, nor did they differ significantly over time, adds the team.

Although, again, not statistically significant, at the 15-minute time point, no patient in the PI group had bacteremia, compared with 17% of the CHX group and 30% of the saline group, hinting that a PI mouthwash might offer most protection against bacteremia.

Of the positive blood cultures, 58% contained anerobic bacteria, and 42% contained aerobic bacteria, with the vast majority (92%; a total of nine species) of both being Streptococcus bacteria.

"Infections originating from oral and dental sources decrease the quality of life of patients and sometimes cause life-threatening complications," write the authors, who give the examples of patients with a congenital cardiac disorder or who carry a heart prosthesis.

One possible explanation for the presence of the bacteria seen in this population after tooth extraction could be the rich bacterial flora present on the tooth surface and in the gingival sulcus of erupted teeth, they note.

"The results of this study should be confirmed with further studies conducted on a larger patient population and with different antiseptic mouthrinses," the team concludes.

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