Transient Bacteremia After Dental Manipulation

To the Editor.—The recent communication by Speck et al,¹raises a very intriguing question: Is the problem of bacteremia following dental "manipulation" different in the pediatric age group? The authors, on the basis of their data, state that "we believe that most routine dental procedures in children of this age group are not associated with bacteremia" and recommend that "we do not feel it efficacious to give antibacterial prophylaxis to pediatric patients with heart disease prior to all forms of dental manipulation," but continue to use prophylaxis in children "prior to extraction of abscessed teeth." In the face of available evidence in the literature, I do not believe that the data from the 32 cultures reported are sufficient to justify alteration of present prophylactic regimens.² There is irrefutable evidence in the literature of bacteremia following dental procedures. Bacteremia has been discussed most often in relation to tooth