Pediatric patients with moderate to severe dental abnormalities were screened for bacteremia during restoration and/or extraction of carious teeth under general anesthesia. Blood cultures were obtained before nasotracheal intubation, after intubation, after restoration of carious teeth but before extraction, following extraction of teeth, and in the immediate postoperative period. All cultures before intubation were negative in the 34 children studied. Twelve percent were positive after nasotracheal intubation (p < .05), 16% were positive after restoration of carious teeth (p < 0.025), 65% were positive after extraction of carious teeth (p < .0005), and 14% were positive in the recovery room (p < .025). Although the incidence of bacteremia in these pediatric patients was lower than the incidence reported in adults following dental procedures, the need for the prophylactic administration of antibiotics in children with heart disease who are to undergo dental manipulations is clear.