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J Dent Res 16(6): 521-530, 1937
© 1937 International and American Associations for Dental Research
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BACTEREMIAS FOLLOWING DENTAL EXTRACTION. DEMONSTRATION OF SOURCE OF BACTERIA BY MEANS OF A NON-PATHOGEN (SERRATIA MARCESENS)

LESTER W. BURKET D.D.S., M.D.1 and CASPAR G. BURN M.D.1

1 Department of Pathology, School of Medicine, Yale University, New Haven, Conn.

Bacteremias of organisms other than Serratia marcesens were demonstrated in 16.9 per cent of the cases after the removal of teeth under novocaine anesthesia. The frequency of bacteremias could not be associated definitely with the degree of oral sepsis or the severity of the operative procedure. The inability to correlate the incidence of bacteremias with the degree of oral sepsis may be explained by the majority of the cases falling in one clinical division.

Repeated blood cultures revealed that the bacteremias were transient. No specific serological changes in the blood stream were observed following bacteremias with Serratia marcesens or other organisms.

The lower incidence of bacteremias (17 per cent), as compared with Okell and Elliot's findings (60-76 per cent) may be due to the use of injection anesthesia in which 1:20,000 adrenalin plays a significant rôle as a vaso-constricting agent.

Attempts to sterilize the gingival crevice revealed the inadequacy of the method and antiseptic used. Although the bacterial flora was quantitatively markedly reduced after treatment, in many instances pure cultures of Streptococcus viridans were grown from the gingival crevice. This may be of significance in the interpretation of periapical cultures made on extracted teeth.

The use of Serratia marcesens demonstrated that organisms in the gingival crevice can be forced into the blood stream during dental extractions. This observation emphasizes the necessity for improved methods of sterilizing the gingival crevice prior to extraction, and caution in performing intra-oral operative procedures on chronically ill individuals.




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