Smoking or poor oral hygiene do not predispose to peritonsillar abscesses via changes in oral flora

Abstract

Aim: The purpose of this prospective study was to determine if there is a difference in number and distribution of salivary bacteria between patients with tonsillar infection and healthy volunteers.

Background: The etiology of peritonsillar abscess (PTA) is unclear. Smoking, periodontal disease, and infection of minor salivary glands have been suggested as predisposing factors for PTA.

Material and methods: Patients with acute tonsillitis (AT) (n = 54), peritonsillitis (PT) (n = 36), PTA (n = 58), and healthy volunteers (n = 52) were prospectively recruited and evaluated. Saliva bacteria were analyzed with flow cytometry. Patients and their treating physicians completed a questionnaire about patients’ current disease, smoking habits, alcohol consumption, and oral health.

Results: There were no differences in the total number of saliva bacteria between patients with acute throat infection and healthy volunteers (p = .104) or between AT, PT, and PTA patients (p = .273). Smoking habits, alcohol consumption, oral hygiene, or prior antibiotics had no effect on total amount of salivary bacteria in patients with acute throat infection.

Conclusions: The effects of smoking on salivary bacteria do not seem to be the mechanism that promotes development of PTA in smokers.

Chinese abstract

目的：本前瞻性研究旨在确定扁桃体炎患者与健康志愿者之间唾液细菌的数量和分布是否存在差异。

背景：扁桃体周围脓肿（PTA）的病因尚不清楚。吸烟、牙周病和小唾液腺感染被认为是PTA的诱发因素。

材料和方法：对急性扁桃体炎（AT）（n=54）、扁桃体炎（PT）（n=36）、扁桃体周围脓肿PTA（n=58）和健康志愿者（n=52）进行前瞻性招募并评估。用流式细胞仪分析唾液细菌。患者及其治疗医生完成了关于患者当前疾病、吸烟习惯、饮酒和口腔健康的问卷调查。

结果：急性喉部感染患者与健康志愿者唾液细菌总数无明显差异（P=0.104）, AT、PT、PTA患者唾液细菌总数也无明显差异（P=0.273）。吸烟习惯、饮酒、口腔卫生或既往抗生素对急性喉部感染患者唾液细菌总量无影响。

结论：吸烟对唾液细菌的影响似乎不是导致吸烟者PTA发病的机制。

Keywords:

• Salivary bacteria
• tonsillar infection
• flow cytometry

Acknowledgments

Timo Pessi performed the statistical analysis with the authors.

Disclosure statement

The authors report no conflict of interest.

Informed consent

All patients and healthy volunteers provided written informed consent to participate in the original study and for use of their samples also in future studies.

Additional information

Funding

This work was supported by the Helsinki University Hospital Research Fund and the Finska Läkaresällskapet.