Antibiotic prophylaxis in dental patients with ventriculo-peritoneal shunts: a pilot study.

Fourteen hydrocephalic children with ventriculo-peritoneal shunts received routine dental prophylaxis and topical fluoride application. No antibiotics were administered to these children for any reason during the three months before treatment or during the twelve months after treatment. None of these children presented with any signs of shunt infection during the twelve-month posttreatment period. In spite of the small sample size, this prospective pilot study suggests that patients with ventriculo-peritoneal shunts are not susceptible to shunt infection following a bacteremia induced by a dental prophylaxis and topical fluoride treatment. Dental prophylaxis without antibiotic coverage in patients with V-P shunts, therefore, does appear safe. We recommend that further study with a larger population, or a collaborative study by several medical centers, be performed to establish more conclusively that prophylactic antibiotics are not necessary for patients with ventriculo-peritoneal shunts who receive dental procedures. In addition, other investigations are needed to determine the risk of shunt infection with more invasive dental procedures, such as periodontal surgery or tooth extraction.