Science in the News
Nontuberculosis Mycobacterial Infection Linked to Pulpotomy Procedures and Possible Dental Waterline Contamination Reported in California and Georgia
September 21, 2016
Recent news items1, 2
have reported on one confirmed case of Mycobacterium abscessus
oral infection in a pediatric dental patient in Anaheim, California. As reported, 7 patients treated at the Children’s Dental Group since May 3, 2016 have been hospitalized with serious oral cellulitis; all of the patients had undergone pulpotomy procedures at the clinic.2
It is estimated that up to 500 children could be affected.1 M. abscessus
is a rapidly growing, nontuberculous mycobacterium (NTM) found commonly in water, soil, and dust and can be a contaminant of medical devices; infection with M. abscessus
can result in dental abscesses and other skin and soft tissue infections.2, 3
The Los Angeles Times
that the California Department of Public Health, the Centers for Disease Control and Prevention (CDC), and the Dental Board of California are working with the Orange County Health Care Agency to investigate the source of the infections.
A related 2016 report3
from the CDC and the Georgia Department of Public Health described the first incidence of transmission of M. abscessus
to patients via dental waterline in a pediatric dentistry practice. It was determined that the practice was using tap water for pulpotomy procedures without water quality monitoring or bleaching of waterlines at the end of each day (as recommended by the manufacturer). Of 1,386 pulpotomies performed since January 2014, a total of 20 patients with confirmed (n=11) or probable (n=9) M. abscessus
infections were identified (as of January 2016). All patients were severely ill and required at least one hospitalization (median hospital stay 7 days; range: 1–17 days); 17 patients required surgical excision and 10 received outpatient IV antibiotics. As of April 5, 2016, no deaths had resulted from infection.
The ADA Oral Health Topics include professional resources on dental unit waterlines
and infection control
Prepared by: Center for Scientific Information, ADA Science Institute
- Perkes C. 7 children hospitalized after treatment at Anaheim dental clinic, 500 more could be affected. The Orange County Register. September 13, 2016 (Updated September 14, 2016). Accessed September 16, 2016.
- Rocha V. Oral infection outbreak appears linked to an Anaheim dental office, officials say. Los Angeles Times. September 14, 2016. Accessed September 16, 2016.
- Peralta G, Tobin-D'Angelo M, Parham A, et al. Notes from the Field: Mycobacterium abscessus Infections Among Patients of a Pediatric Dentistry Practice--Georgia, 2015. Accessed September 15, 2016.
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