Storm, R. (2013) Het risico op een endocarditis na een tandheelkundige ingreep. thesis, Dentistry.
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Abstract
Endocarditis is an infection of the endocard due to an enormous invasion of bacteria in the bloodstream that attach to damaged endocard. Patients who have certain heart defects, heart valve prostheses or have undergone an endocarditis, have an increased risk of developing the infection. Unfortunately and by contrast, the infection can strike anyone, though the incidence for people without heart defects is very low. Patients at risk for an endocarditis usually are prescribed a prophylaxis before an intervention in the oral cavity, the upper airways, infected tissue and in the urogenital system to prevent a bacterial endocarditis from happening, The current prophylaxis policy, by means of a national guideline, clearly describes the indication for an endocarditis prophylaxis. There is some debate whether invasive dental treatments may trigger an endocarditis. After all, a bacteremia due to daily activities such as tooth brushing and flossing is addressed to everyone and their risks by daily routine may be much larger than the bacteremia caused by dental work. In this study, the association between invasieve dental treatments and the development of an endocarditis has been analyzed. Dental records of 76 patients that have had an endocarditis in the UMCG have been matched with a group of patients from the dental school (patient control study). The data was analyzed by means of a univariate and multivariate logistic regression analysis. Results showed that there was no association between invasive dental treatments and the development of an endocarditis. Therefore it seems very unlikely that an invasive dental treatment is a serious risk for developing an endocarditis. However, in one third of the patients who had an endocarditis, bacteria from the oral cavity were found in the infected endocard tissue. An explanation for this finding is that bacteria ended up in the bloodstream due to daily activities such as tooth brushing. Only four out of 39 dental records contained information about the dental hygiene of patients in the experimental group. Due to this lack of information, the relationship between pour dental hygiene and a bacteremia could not be analyzed. A prophylaxis is nowadays still advised before an invasive dental treatment but has been limited to fewer conditions in the latest guidelines. Still, there is no convincing scientifically prove that a prophylaxis is necessary and extreme measures of safety seem to play a big role in the formation of the current guidelines. More research is necessary to improve the policy for preventing an endocarditis.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Huddleston Slater, dr. J.J.R. and Afd Kaakchirurgie |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:42 |
| Last Modified: | 25 Jun 2020 10:42 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/367 |
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