Dental Plaque and Oral Flora in the Compromised Patient

DENTAL PLAQUE AND ORAL FLORA IN THE COMPROMISED PATIENT

As it can be the source of transient bacteremia, dental plaque must be viewed as a hazard in the compromised patient. The best example is the patient with heart valve damage as a result of a congenital anomaly, rheumatic fever, or a heart prosthesis. If transient bac-teremia develops, the blood-borne bacteria may form vegetative growths in the heart and cause bacterial endocarditis . Such patients should always be premed-icated with prophylactic antibiotics before any dental procedure with the potential for causing a bacteremia is performed, including routine dental prophylaxis.

It has also been established that dental plaque organisms and other oral bacteria may give rise to serious systemic infections in patients whose host defense mechanisms are compromised. Patients who have undergone extensive radiation treatment of the jaw area, for example, are prone to develop osteomyelitis. Furthermore, one of the most frequent sources of fatal infections in leukemic patients is the oral cavity. Therefore, for these patients scrupulous home care and professional dental treatment are indicated prior to un-dergoing immunosuppressive therapies.