The human mouth is colonised by a huge variety of bacteria. When surgical procedures such as a tooth extraction are carried out, the bacteria can pass into the bloodstream causing bacteraemia that is generally transient. What is not yet clear is how significant this presence of bacteria in the blood is in terms of the origin and evolution of infectious processes such as endocarditis of the heart valves, prosthetic valves, hip and knee joint replacements generally, and in local infection.
Numerous studies have shown that a mouthwash containing chlorhexidine has a powerful antimicrobial effect on saliva microflora and bacterial plaque. “On the basis of this hypothesis we can assume that antimicrobial mouthwashes used before the dental procedure should reduce the number of micro-organisms that pass into the patient’s bloodstream, yet this is a hotly debated issue,” the members of a UPV/EHU’s research group write.
In 1997, the American Heart Association (AHA) suggested that patients at risk of infectious endocarditis should use an antimicrobial mouthwash before a dental procedure. In 2006, the British Society for Antimicrobial Chemotherapy (BSAC) recommended a single mouthwash with 0.2 percent chlorhexidine (CHX) (10 ml for 1 minute) before carrying out dental procedures associated with bacteraemia. Yet in 2007 the AHA recommended against adopting any antiseptic prophylaxis protocol.
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