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Limiting antibiotic in dentistry

By Dr. Shawn M Keller

Less is More- Limiting use of Antibiotics in Modern Dental Treatment

Although these antibiotics can help fight the bacteria associated with most dental infections, they are rarely used as the primary therapy alone.

The use of antibiotics has been a routine part of dental treatment for decades. The antibiotics seattle dentists most often prescribe include Penicillin, Erythromycin, Clindamycin, Tetracycline or their derivatives. Although these antibiotics can help fight the bacteria associated with most dental infections, they are rarely used as the primary therapy alone. To the contrary, most dental infections are treated surgically, with antibiotics used in an occasional, supplemental role. For instance, an infected tooth is often treated by the removal of its nerves and tiny blood vessels (root canal) or by having the tooth removed. An infection of the gum is treated by using a small, thin curette and removing the bacterial build-up (plaque and tartar), or by removal of the infected gum and other surrounding tissue.

So when should your seattle dentist prescribe antibiotics? To answer that question, let me begin with what many dentists have done in the past. In most cases, antibiotics were routinely given after root canal treatment, surgical dental extractions, and after gum surgery. Today, I almost never prescribe antibiotics for these procedures. The reason is that experience and research have shown that in the majority of cases, antibiotics are not necessary. I would also add that the use of antibiotics should not be taken lightly. The emergence of drug resistant bacteria, side effects, and potentially dangerous allergic reactions are all reasons for dentists to be very prudent in the administration of antibiotics.

Despite the potential risks associated with their use, there are legitimate reasons for the use of antibiotics in dentistry. Antibiotics are often used to treat persistent or advanced dental infections that do not respond to routine treatment alone. They are also used after complex gum or implant surgeries, especially those that use grafts, or when treating dental infections for those that have diseases or take medications that suppress the immune system. Antibiotics should also be taken prior to dental treatment for patients who are considered at high risk for developing subacute bacterial endocarditis (SBE), a dangerous heart infection. People at risk are those with artificial heart valves, have had SBE in the past, have congenital (occurring at birth) heart defects, have damaged heart valves from diseases such as rheumatic heart disease, and those who have certain heart murmurs. In some cases, antibiotics can be given several days before treatment including root canal or having a tooth removed to reduce the severity of the infection, allowing treatment to proceed more easily.

The decision whether to use antibiotics is at the discretion of your seattle dentist. Every individual situation is different, and will not necessarily fall neatly into the categories that I have described. Even so, the use of antibiotics in most dental treatment has now become a more limited and selective process.

About the author:
Dr. Keller a seattle dentist has written numerous articles on issues related to dentistry which can be found at

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