Reducing Risk for Infective Endocarditis

NCT ID: NCT05721781

Last Updated: 2025-08-22

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

320 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-08-31

Study Completion Date

2027-09-30

Brief Summary

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This clinical trial is studying if bacteria found in a participant's bloodstream after brushing their teeth can be prevented with a dental cleaning and more education on how to best brush and care for their teeth. One group of participants will have a dental cleaning and oral health instructions and the other group of participants will not. Researchers will compare the blood test results from the two groups to see if the education made a difference in preventing bacteria and how long it stays in the bloodstream.

Detailed Description

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This multi-center randomized clinical trial will determine if an intervention to improve oral hygiene and reduce gingival inflammation decreases the incidence and duration of bacteremia of Infective Endocarditis (IE) causing bacterial species, which may refocus longstanding guidelines on prevention for all people at risk for Infective Endocarditis (IE). The Standardized Brushing Hygienist will brush the participant's teeth over a 2-minute period, during and after which there will be 4 additional blood samples. The participant will then be randomized to an intervention or routine care group. The intervention will consist of a single session of tooth scaling and polishing, and oral hygiene instruction provided at the end of the Randomization Visit. Both groups will return for 3-week and 15-week visits, during which they will undergo a non-invasive oral examination and the brushing procedure with 5 blood samples (baseline and 4 additional blood samples after brushing begins). All blood samples will be cultured for bacteria of IE causing species.

Conditions

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Bacteremia Infective Endocarditis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

DOUBLE

Investigators Outcome Assessors

Study Groups

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Participants receiving a dental cleaning and oral hygiene instruction

Participants randomized to this arm will receive a standard dental cleaning and education on proper toothbrushing and flossing technique and asked to follow these toothbrushing and flossing techniques for the duration of the study period. They will receive periodic phone call reminders to maintain these practices during the study period.

Group Type EXPERIMENTAL

Oral Hygiene instruction

Intervention Type BEHAVIORAL

Participants will be instructed on the Modified Bass technique for toothbrushing: brushing with a soft bristled toothbrush held at a 45 degree angle to the gums and brushed in a circular motion. Participants will also be instructed to floss at least once per day using floss or another inter-dental device (e.g., floss pick).

Dental Cleaning

Intervention Type PROCEDURE

Participants will receive a dental cleaning according to the current standard of care for routine dental cleanings.

Control

Participants randomized to this arm will be instructed to continue with their usual oral hygiene practices for the duration of the study period.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Oral Hygiene instruction

Participants will be instructed on the Modified Bass technique for toothbrushing: brushing with a soft bristled toothbrush held at a 45 degree angle to the gums and brushed in a circular motion. Participants will also be instructed to floss at least once per day using floss or another inter-dental device (e.g., floss pick).

Intervention Type BEHAVIORAL

Dental Cleaning

Participants will receive a dental cleaning according to the current standard of care for routine dental cleanings.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Age 18 years or older.
* Greater than 6 months since last dental hygiene prophylaxis (cleaning).
* 10 or more accessible teeth (including implants, with a minimum of 8 natural teeth).
* Willing and able to provide informed consent.
* Willing to comply with all study procedures and be available for the duration of the study.
* Willing to forgo routine professional dental cleanings while enrolled in the trial.

Exclusion Criteria

* At high risk for IE, as defined by the 2007/2021 AHA Guidelines:
* Prosthetic cardiac valve or prosthetic material used for cardiac valve repair.
* Previous episode of IE.
* Cardiac transplantation recipient with cardiac valvulopathy.
* Specific congenital heart disease conditions.
* Pregnant, by self-report, or planning to become pregnant during the study period.
* Affected by a condition that, in the opinion of the investigator, may preclude them from study completion or put them at increased risk such as :
* Hemodialysis dependent.
* Have a long-term intravascular catheter (e.g., for chemotherapy or parenteral nutrition).
* Active injection drug use (IDU).
* Clotting disorder such as, hemophilia.
* Have a solid organ transplant or hematopoietic stem cell transplant, or ongoing treatment for hematologic cancer.
* Currently incarcerated.
* Systemic antibiotic use within the past 2 weeks.
* Undergoing orthodontic treatment with fixed appliances (brackets and wires) or plans to do so during the study period.
* Taking or requiring antibiotic prophylaxis prior to dental procedures for other reasons, e.g., to prevent prosthetic joint infection .
* Three or more teeth with moderate to severe gingival hyperplasia.
* Has clinically detectable emergent or urgent dental needs that, in the trained and calibrated Oral Examiner's opinion, would require definitive dental care during the study period.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Wake Forest University Health Sciences

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Peter Lockhart, DDS

Role: PRINCIPAL_INVESTIGATOR

Wake Forest University Health Sciences

Locations

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Tufts University School of Dental Medicine and Tufts University Health Sciences Campus

Boston, Massachusetts, United States

Site Status WITHDRAWN

University of Michigan School of Dentistry and Michigan Medicine

Ann Arbor, Michigan, United States

Site Status RECRUITING

Rutgers School of Dental Medicine

Newark, New Jersey, United States

Site Status COMPLETED

New York University

New York, New York, United States

Site Status NOT_YET_RECRUITING

University of Rochester Medical Center

Rochester, New York, United States

Site Status ACTIVE_NOT_RECRUITING

Atrium Health's Carolinas Medical Center

Charlotte, North Carolina, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Cathy Petersen, RDH

Role: CONTACT

704-355-1494

Kate Sullivan, MA

Role: CONTACT

704-355-9496

Facility Contacts

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Mary Burton

Role: primary

Leticia Arbex

Role: primary

212-998-9800

Mariana Bucovsky

Role: backup

Cathleen Petersen, RDH

Role: primary

704-355-1494

Other Identifiers

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IRB00092954

Identifier Type: -

Identifier Source: org_study_id

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