Chewing fails to induce oral bacteraemia in patients with periodontal disease

Aim: To investigate whether chewing in patients with untreated chronic periodontitis or plaque-induced gingivitis causes bacteraemia of oral origin. Method: Twenty-one patients with untreated chronic periodontitis (32-75 years old) and 20 with plaque-induced gingivitis (26-54 years old) chewed a standard wax medium for 4 min. Blood samples were drawn before, during and 5 min. post-chewing. Aerobic and anaerobic Bactec system culturing was performed for 21 days and positive bottles were subcultured and isolates were identified to genus level. A full periodontal analysis was performed on all teeth and included probing depths, recession, attachment levels, bleeding on probing, mobility plaque index and gingival index. Radiographs were assessed for the severity of alveolar bone loss. Results: No bacteraemia of oral origin was detected in any patient. Skin contaminants (Staphylococcus epidermidis, Propionibacterium spp.) were detected in blood samples from three patients (two periodontitis; one gingivitis). Conclusion: Chewing did not cause bacteraemia in chronic periodontitis or plaque-induced gingivitis patients and may not be a risk factor for infective endocarditis in at-risk individuals with periodontal disease.