Background Brain abscesses are frequently caused by oral cavity bacteria, but whether dental status and invasive dental procedures are important risk factors is unknown. Methods A nationwide, population-based, case-control study examined the association between dentist’s visits and invasive dental procedures and risk of brain abscess caused by oral cavity bacteria from 1989 through 2016. Date of brain abscess diagnosis was considered the index date. Using risk-set sampling, 10 population controls per case were individually matched by age, sex, and residential area. Conditional logistic regression was used to compute odds ratios with 95% confidence intervals (CIs), adjusted for comorbidity. Results We identified 362 patients with culture-proven brain abscess caused by oral cavity bacteria. The median age was 53 years (interquartile range, 39–65 years) and 220 (61%) were male. Invasive dental procedures within 6 months before the index date was observed in 21 of 362 (6%) patients with brain abscess and 179 of 3257 (5%) population controls (adjusted odds ratio [aOR], 1.07 [95% CI, .67–1.70]). Two hundred thirteen of 362 (59%) patients with brain abscess had visited their dentist within 1 year before the index date compared with 1944 of 3257 (60%) of population controls (aOR, 0.99 [95% CI, .77–1.26]). Using no dentist’s visits as reference, we observed aORs of 0.95 (95% CI, .64–1.40) for 1–2 visits within 3 years of the index date and 1.01 (95% CI, .76–1.35) for 3 or more visits. Conclusions Recent invasive dental procedures and number of dentist’s visits were not associated with culture-verified brain abscess caused by oral cavity bacteria.

中文翻译：

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牙医就诊和脑脓肿的风险：一项全国性的、基于人群的病例对照研究

背景 脑脓肿通常是由口腔细菌引起的，但牙齿状况和侵入性牙科手术是否是重要的危险因素尚不清楚。方法 一项全国性的、以人群为基础的病例对照研究调查了 1989 年至 2016 年间牙医就诊和侵入性牙科手术与口腔细菌引起的脑脓肿风险之间的关系。脑脓肿诊断日期被视为索引日期。使用风险集抽样，每个病例 10 个人群对照按年龄、性别和居住区域进行单独匹配。使用条件逻辑回归来计算 95% 置信区间 (CI) 的比值比，并根据合并症进行调整。结果 我们确定了 362 名经培养证实由口腔细菌引起的脑脓肿患者。中位年龄为 53 岁（四分位数范围，39-65 岁），其中 220 名（61%）为男性。在 362 名脑脓肿患者中的 21 名 (6%) 和 3257 名对照人群中的 179 名 (5%) 中观察到索引日期前 6 个月内进行过侵入性牙科手术（调整后比值比 [aOR]，1.07 [95% CI，0.67] –1.70]）。362 名脑脓肿患者中，有 213 名 (59%) 在索引日期前 1 年内看过牙医，而 1944 年则有 3257 名对照人群 (60%) (aOR, 0.99 [95% CI, 0.77–1.26] ）。以没有牙医就诊作为参考，我们观察到索引日期后 3 年内 1-2 次就诊的 aOR 为 0.95（95% CI，0.64-1.40），3 次或以上就诊的 aOR 为 1.01（95% CI，0.76-1.35）访问。结论 最近的侵入性牙科手术和看牙医的次数与经培养证实的口腔细菌引起的脑脓肿无关。