Are Antibiotics Really Necessary?

In most dental cases, antibiotics are not needed. Read on to learn when antibiotics are appropriate in an endodontic setting. Thanks for visiting Surrey Endodontic Centre. 

Based on the wide variety of prescription antibiotics that have been given to patients presenting to my office for evaluation and possible treatment, there seems to be a significant misunderstanding and controversy around the topic. The confusion stems from being able to determine when a prescription is needed and what to prescribe; if a prescription is necessary, the dosage, frequency and duration can also cause some confusion.

I’d like to eliminate some of this misperception about the use of antibiotics for patients with disease of endodontic origin, and suggest that most of the antibiotic prescriptions dispensed for tooth pain are unnecessary, and in fact, inappropriate.

Not all diagnoses warrant antibiotic therapy
Before prescribing any drug, an appropriate diagnosis must be made. If the diagnosis warrants the need for antibiotics, then the most appropriate medications may be assessed. According the Center for Disease Control and Prevention (CDC), nearly half of all antibiotic prescriptions are improperly dispensed. This certainly seems to be the case in dentistry since antibiotics are routinely prescribed for patients in pain – especially pain suspected to be of endodontic origin. Pain by itself, however, is an inappropriate symptom to treat using antibiotics as no reputable clinician would prescribe antibiotics to treat back pain. When a dental patient in pain is determined to have an irreversible pulpitis from deep caries and implying a vital pulp, the appropriate treatment is endodontic therapy or extraction along with pain medication.

If a patient presents with pain of odontogenic origin and the diagnosis is necrotic pulp, the pulp may or may not be infected. In either case, the appropriate treatment is once again, endodontic therapy or extraction. In other words, the source of infection or potential infection should first be removed. If the patient is swollen, has swollen nodes and an elevated body temperature, this may suggest systemic involvement and the presence of an infection too severe for their natural immune system to handle. Only in these rare circumstances would antibiotic therapy be indicated.

Again, let me say that antibiotics are rarely required in outpatient dental treatment and their overuse is causing more harm than good. According to the CDC, antibiotic resistance is so common that it has been a concern for years and is considered one of the world’s most critical public health threats.

Continue reading HERE.