Do We Need Antibiotics When We See The Dentist? – Ask Dr. Farooq Sorathia
Antibiotics In Dentistry: Do We Need Antibiotics When We See The Dentist?
The use of antibiotics in dentistry has been one of the most discussed topics around the globe, and unfortunately, there is none with a universal consensus as to the appropriate use of antibiotics. Each patient needs to be treated on a case-by-case basis.
In 1928, Alexander Fleming had a Eureka moment, when he noticed that an uncovered Petri dish near an open window was contaminated by mould, and with that, he noticed that the bacteria around the mould survive in the presence of this mould. This was the discovery of penicillin, which is an antibiotic that is still used to date.
Antibiotics have a role to play in dentistry. I have had many patients come to me for tooth extraction, and once that is done, I give them a prescription for a pain killer with some post-operative instructions. To their surprise, they ask, “Doc, what about the antibiotic?”. It was believed when a tooth has to be extracted, the patient needs to be on antibiotics to clear the infection. This is a myth, and it is up to the dentist to decide if the patient requires antibiotics or not. The dentist is a trained health care professional who not only considers what is happening in the mouth but considers the whole body.
As I mentioned earlier, there are some cases in which studies show that antibiotics are beneficial before receiving dental treatment. Such an example is if a patient has certain heart conditions, they require antibiotics before receiving (selective) dental treatment to prevent damage to the structures of the heart. The mouth harbours over 500 different species of bacteria. During dental treatment, some of these bacteria can be introduced into the bloodstream and can travel and cause damage to a diseased heart. This is something that has to be avoided. This is the reason I say, that a dentist is a trained health professional who knows the advantages or disadvantages of the use of antibiotics.
Before 2017, people who have had joint replacements such as hip or knee replacements, have required antibiotics before receiving dental treatment. Once again, I must stress that not all procedures in dentistry require prior antibiotics with patients having these conditions. The American Academy of Orthopedic surgeons recommended that antibiotic therapy before receiving dental treatments such as extractions, or teeth cleaning, or even oral surgery would not be necessary.
As science evolves, we continue to learn more every day, and the more we learn, the more we change!
