TREATING TOOTH INFECTIONS



ANTIBIOTIC TREATMENT:

Dental infections often will need to be treated with ANTIBIOTICS.

Common antibiotics include,

  • Penicillin
  • Amoxicillin
  • Erythromycin
  • Clindamycin
  • Clarithromycin

There are indications for antibiotics in the dental field, but there is a risk to their overuse.

OVERUSE: If antibiotics are overused, the bacteria it is intended to fight, can develop a resistance, which can cause antibiotics to be ineffective.

Therefore, LET YOUR PROVIDER decide when and when not to prescribe them!

WHEN TO USE:

SWELLING: If you are swollen, you will likely need antibiotic therapy.

INFECTIONS: Some dental infections do not require antibiotics. For example, if your tooth is infected and a root canal is started or the tooth is extracted , you may not need antibiotics.

Sometimes removing the source of the infection, will allow the infection to clear up on its own.

DURATION: Antibiotics are usually given for 7-10 days. It often takes 1-2 days for the antibiotics to start working, so do not give up on them after only 1 day. On the other hand, it may take 7-10 days for all the bugs to be killed, therefore, if your swelling goes down after 3 days, continue to take the antibiotics as directed



ANTIBIOTIC PREMEDICATION:

There are certain medical conditions which require the patient to take a dose of antibiotics prior to their dental appointment. This is done to help prevent any bacteria introduced from the dental procedure, from causing an infection in the heart tissue (infective endocarditis) or prosthetic joints.

This is a very controversial practice, as research is inconclusive whether it is beneficial or not, and the recommendations have been scaled back consistently over the years. The existing conditions which previously required prophylactic antibiotic coverage has decreased, as has the dosage of antibiotics.

Visit our Premedication page for recent recommendations

CONDITIONS WHICH HISTORICALLYL REQUIRE PREMEDICATION: (This list is not all inclusive, so check with your provider if you have any concerns)

  • History of Rheumatic Fever
  • Joint Replacement
  • Kidney Dialysis
  • Mitral Valve Prolapse with Valvular Regurgitation
  • History of Bacterial Endocarditis
  • Certain Congenital Heart Conditions
  • Heart Transplant

DENTAL PROCEDURES WHICH REQUIRE PREMEDICATION: (This list is not all inclusive, so check with your provider if you have any concerns)

If significant bleeding is not going to occur, it is not necessary to take antibiotics prophylactically before your dental appointment.

YES, ANTIBIOTICS ARE NEEDED:

  • Extractions
  • Periodontal Surgery
  • Endodontic Surgery
  • Root Canal Therapy
  • Periodontal Cleanings

NO, ANTIBIOTICS ARE NOT NEEDED:

  • Routine Fillings
  • Routine Crown Preparations
  • Routine Dental Cleanings
  • Orthodontic Placement of Bands or Brackets
  • Dental Xrays or Radiographs

DOSAGE:

AMOXICILLIN, usually administered as 500mg x 4 tablets (2.0 grams), taken 1 hour before dental appointment.

or, if allergic to amoxicillin

CLINDAMYCIN, usually administered as 150mg x 4 tablets (600mg), taken 1 hour before dental appointment.

In general because of the changing requirements, when in doubt it is always a good idea to check with the patient's cardiologist or physician, and comply with their recommendations.


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