Q: I recently had a tooth extracted and had quite a bit of discomfort for several days. My sister is a nurse and was surprised that the my doctor did not prescribe antibiotics. Is she right? Dawn in Royal Palm Beach
A: I don’t want to put a scalpel between siblings, but I beg to differ with your sister. (The last time I agreed with my two sisters, I was watching the first season of All in the Family.)
In January 2013 the Clinicians Report Newsletter published a consensus of antibiotic guidelines following various dental procedures. (Note: these are not the guidelines related to pre-medicating before dental work due to artificial joints or heart issues. That is a topic for another column. )
Removal of single teeth, weather routine or involving surgical cutting as in impactions, without signs of infection (puss, swelling, fever, or radiographic findings) do not require antibiotics. The pain patients experience is due to normal postoperative pain much like those that have had orthopedic surgery; or any type of surgery for that matter.
Antibiotics are usually given after the removal of many teeth at once, infected teeth, “hot” teeth, ie. teeth with acute pain and in patients who have certain medical problems such as diabetes. We also prescribe antibiotics following implant placement and bone grafts to help prevent rejection. As far as which antibiotics? The most common ones used are Penicillin, Amoxicillin, Clindamycin and Cephalexin.
Note: Dr. Josephs’ FREE seminar on Hi-Tech Implant, Cosmetic and General Dentistry is available for your next meeting. His multi media presentation is perfect for country clubs, community centers, churches and synagogues, private groups, hospitals and healthcare facilities. Please contact 561-832-2917 to book your next event.
Dr. Mitchell Josephs practices Implant Cosmetic and General Dentistry and hosts “Tooth Talk” on WBZT AM123.0 Dr. Josephs is on staff at West Palm Hospital (Formerly Columbia Hospital) and is a Faculty Advisory Board member at McGill University’s Faculty of Dentistry and completed his residency at Manhattan’s Beth Israel Medical Center and Mt. Sinai Hospital.