Are Antibiotics Necessary After A Tooth Extraction
The answer is that it depends on our overall health and how big the dental infection was. Our mouths are full of bacteria at all times and it is impossible to sterilize your mouth. The good news is that there are good and also bad bacteria. For most healthy patients, our body’s immune system should be able to fight off all infections even with a tooth removal.
The only evidence you need is, do you recall taking antibiotics every time one of your baby teeth fell off? You probably didn’t take any right? So, does that apply to adult teeth as well?
Video Transcription Antibiotics For Implants:
Hello Ramsey Amin, DDS here. Antibiotics are always a big topic of discussion and can antibiotics help my tooth? Do I need antibiotics before an extraction, after an extraction, before a bone graft, after a bone graft? Theres so many different times that we may need the benefit of antibiotics and perhaps sometimes we do not. Most often I receive a question online about a failing tooth that you were told is infected and needs to be removed. And a question arises, well, should I be on antibiotics? Most infections that are within teeth are oftentimes at the apex or the end of the root. They are oftentimes around a root canal tooth that is treatment plan for extraction because its fractured or a crown can not be made for it. And these infections, quote unquote, or inflammation are chronic in nature typically.
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Who Needs Antibiotics Before Dental Work
Most patients don’t require antibiotics before dental work. Immune systems are more than capable of handling these bacteria, but there are some people who may need antibiotics after oral surgery. This may include those have had or have:
- Heart conditions, including congenital heart defects and disease
- An artificial heart valve
- Knee or hip replacement surgery
- Infective endocarditis
Always make sure to share your full medical history with your doctor before surgery or dental work, even if you think it’s not relevant, so they know if they need to prescribe antibiotics before or after dental work.
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Reasons For Pulling Teeth
Although permanent teeth were meant to last a lifetime, there are a number of reasons why tooth extraction may be needed. A very common reason involves a tooth that is too badly damaged, from trauma or decay, to be repaired. Other reasons include:
A crowded mouth. Sometimes dentists pull teeth to prepare the mouth for orthodontia. The goal of orthodontia is to properly align the teeth, which may not be possible if your teeth are too big for your mouth. Likewise, if a tooth cannot break through the gum because there is not room in the mouth for it, your dentist may recommend pulling it.
Infection. If tooth decay or damage extends to the pulp — the center of the tooth containing nerves and blood vessels — bacteria in the mouth can enter the pulp, leading to infection. Often this can be corrected with root canal therapy , but if the infection is so severe that antibiotics or RCT do not cure it, extraction may be needed to prevent the spread of infection.
Risk of infection. If your immune system is compromised , even the risk of infection in a particular tooth may be reason enough to pull the tooth.
Periodontal disease. If periodontal disease — an infection of the tissues and bones that surround and support the teeth — have caused loosening of the teeth, it may be necessary to pull the tooth or teeth.
When A Dental Extraction Requires Antibiotics
The most common reason for needing to take antibiotics would be an infection that results in a dental abscess. The abscess is usually accompanied by facial swelling. For large infections with diffuse facial swelling, your dentist will be prescribing you antibiotics even after they’ve extracted the tooth. The prescription is to help you fight and control the swelling after the procedure. It will also help to clear out the abscess faster.
The exception is when you have localized swelling that is caused by an infection. If it is localized, it is actually not required to take antibiotics afterwards. The most important treatment is to perform the extraction and establish a path of drainage for the infection. As long as you achieve that, it is not necessary to take the medication. Although we say that, our LIC dentists may still prescribe you some penicillin because it may be difficult to determine if the swelling whether it is facial swelling of gum swelling is truly localized or diffuse.
Aside from having a dental abscess, the last reason for needing the prescription would be if you had a health condition that requires antibiotic prophylaxis. Taking it is mostly to prevent infective endocarditits.
The prophylaxis is usually 2 grams of amoxicillin for those who are not allergic approximately one hour prior to dental surgery. If you miss the dose, you can still take it after the procedure as well but as soon as possible.
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What Happens During A Tooth Extraction
First, local anesthesia is given to numb your affected tooth and surrounding gum tissue. Using specialized dental instruments, your dentist will gently loosen your tooth and carefully lift it from its socket. Sometimes, your dentist might need to make incisions in your gums to access your tooth especially if your tooth is badly decayed or has broken off at the gum line. Once your tooth is removed, the socket is cleaned and disinfected. In some cases, your dentist may also place a dental bone graft, which helps prevent bone loss in your jaw. Finally, stitches may be placed to help promote healing.
Are Antibiotics Required For Implants
Use of antibiotics should be judicious and carefully thought out. Just because you have an infection in your tooth, it does not mean you need an antibiotic. Also, not all infections are actually infections. Not all infections can be cured by antibiotics alone.
In fact if you are allergic to penicillin please click this link. Being allergic to penicillin carries more risk for implants and bone grafting. Amoxicillin is the most common antibiotic for a tooth infection.
Antibiotics are commonly needed for procedures that involved cutting through bone or addition of bone graft materials. There is a limited supply of new blood vessels that can get your natural immune systems protection in the first few days following a significant procedures such as a surgical extraction, a bone graft, sinus graft, apicoectomy and dental implants.
Antibiotics are extremely helpful in many situations. I also discuss common questions such as antibiotic resistance and what happens with common stomach issues and what to do about them.
I think you will find this video helpful. Please feel free to ask questions below.
Ramsey A. Amin, D.D.S.Diplomate of the American Board of Oral Implantology /Implant DentistryFellow-American Academy of Implant DentistryBurbank, California
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Overview
Dry socket, or alveolar osteitis, may develop after a permanent adult tooth is extracted.
It can occur when the blood clots at the site of extraction either dislodges, dissolves, or never develops prior to healing. This can leave your underlying bone and nerve endings exposed. It also allows the wound to become filled with food or debris, causing infection.
Symptoms of dry socket include:
- severe pain, which may radiate from the socket to your ear, eye, temple, or neck
- seeing an empty socket
- visible bone in the socket
- bad breath or an unpleasant taste in your mouth
The exact causes of dry socket still need more research. The most common causes are:
- bacterial infection
- difficult or complicated extractions, such as an impacted wisdom tooth
- trauma at the surgical site
Youre most at risk of developing dry socket if you:
- take oral contraceptives
- dont follow proper wound care
There are different treatments available for dry socket that your dentist or oral surgeon can prescribe to you. When you have to wait to get into see them, however, these home treatments can help alleviate symptoms.
When Are Antibiotics Used For A Tooth Infection
Tooth infections dont always require antibiotics. In many cases, they may clear up on their own. Rinsing with warm saltwater or taking over-the-counter medicines, such as non-steroidal anti-inflammatory drugs , may help to reduce tooth pain and swelling.
The American Dental Association recommends that dentists avoid prescribing antibiotics for most tooth infections due to potential side effects. Dental treatments, such as drainage, deep cleaning, or a root canal , may sometimes be necessary.
However, your dentist may prescribe antibiotics if you are immunocompromised or if your tooth infection is spreading. Some of the signs that your tooth infection is getting worse may include:
- Swelling in the jaw or neck
- Intense pain or swelling that does not go away
If left untreated, a tooth infection may spread to the surrounding bones and tissues. This can lead to serious health complications, including:
If you have a severe tooth infection, your dentist may prescribe a course of antibiotics to prevent it from spreading. Antibiotics may prevent tooth loss and other serious health complications.
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Tooth Infection Treatment: Whatre Your Options
To treat a tooth abscess, your dentist will perform an exam and often take an x-ray to locate your infection and determine its severity and whether it has spread. Based on these findings, treatment options may include:
- Draining the abscess:Your dentist or healthcare provider will administer a local anesthetic and then create an incision in the abscess to drain the pus.
- Performing a root canal treatment:Your dentist will administer an anesthetic and then drill into your infected tooth to remove the pus collected in its interior. After they clean the area, they will fill, seal, and cap the tooth to complete the root canal procedure and ensure that no more bacteria can enter.
- Extracting the tooth:Your dentist may recommend extracting a tooth if it is too damaged to save. Once they pull your tooth, they will drain the area of any remaining pus to treat the abscess and relieve your pain.
In most cases, the American Dental Association recommends that dentists treat abscesses and other causes of dental pain with appropriate dental procedures and pain relievers, not antibiotics.
To manage your pain, your dentist may suggest taking over-the-counter pain relievers like ibuprofen , acetaminophen , or naproxen before or after your dental procedure.
What Are The Symptoms Of A Dental Infection
Depending on the location and extent of the infection, dental infection symptoms can range from mild to severe. If you have a tooth infection, you may experience one or more of the following symptoms:
- A lump or bulge around the infected tooth
- Throbbing or persistent pain around the infected tooth
- Throbbing or constant pain that radiates to your jaw, neck, or ear
- Pain in your face
- Red, swollen, or bleeding gums
- A swollen mouth or face
- Sensitivity to hot or cold temperatures
- Tenderness or sensitivity to touch around the infected tooth
- A discolored or loose tooth
- Bad breath or a foul taste in your mouth
- Difficulty opening your mouth
If a tooth infection goes untreated, bacteria can spread and infect areas of your jaw, face, head, or neck. In rare instances, your infection can develop into a serious skin infection or blood infection . Symptoms of a tooth infection spreading to body parts outside the mouth include:
- Feeling generally ill or unwell
If you experience these symptoms, seek medical attention from a healthcare provider immediately.
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When Antibiotics Are Usually Not Required
Typically, antibiotics wouldnt be required for routine procedures, such as dental X-rays, a dental examination, a routine dental cleaning, or cosmetic treatment . Additionally, dry socket will not always be treated with antibiotics. Dry socket occurs when the clot that is supposed to form after a tooth extraction or wisdom teeth removal doesnt form properly or is dislodged early. This common complication causes significant oral pain and discomfort but is not necessarily an infection. However, if it was caused by a preexisting bacterial infection or if it develops into an infection, antibiotics will be necessary.
As in general medicine, antibiotics are sometimes prescribed in dentistry. In this article, we offer a brief summary of when dental surgery requires antibiotics, and when it doesnt. For the purpose of this blog post, our working definition of dental surgery includes invasive dental procedures, such as a tooth extraction, fillings and repairs, root canal therapy, dental crowns, gum disease treatment, and dental implants.
What Happens Before A Tooth Extraction
Your dentist will assess your affected tooth and surrounding gums. Your dentist will also take dental X-rays to check bone levels and determine the extent of damage. Be sure to tell your dentist about any medications, vitamins or supplements youre taking. Once all information is gathered, treatment and sedation options will be discussed with you in detail.
Sedation options in dentistry
Many healthcare providers offer sedation during tooth extractions and other dental procedures. Sedation is an excellent option for people who have dental anxiety or for those who simply want to be more comfortable during their appointment. Sedation medications used in dentistry include:
In some instances, your dental provider may recommend general anesthesia in a hospital setting. This option is usually reserved for complex cases, such as facial reconstruction or corrective jaw surgery.
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Post Tooth Extraction Infections & How To Beat Them
Once a tooth has been extracted, bacteria will still be alive in the mouth, even more so with those who have bad oral hygiene. Infections are very common following extractions. Depending on how bad the tooth was that the dentist removed, he may prescribe you some antibiotics to take that will greatly reduce your risk of getting an infection. In some cases though, even antibiotics cant prevent an infection.
If you go to the dentist before the extraction experienced swelling of the face, swollen gums, pain in your teeth under light pressure, or bleeding around the extraction site, then you may already have an infection. If you indeed have an infection before you get the tooth treated, the dentist will prescribe you antibiotics to use following treatment. If you have a really bad abscess, youll need to use antibiotics to treat the infection before the dentist will remove the tooth.
In some cases, people develop an infection after the extraction, even though they may not have been infected beforehand. The reason for this, is bacteria. Following an extraction, bacteria will be more alive in the mouth than ever before. With the extraction site being exposed, the bacteria will be able to get into the site. This can lead to an infection due to the site being exposed and the fact that you are unable to use mouthwash or brush during the first 24 48 hours. Not being able to sterilize your mouth means that you are unable to kills the germs responsible for bacteria.
Facial Swelling With Infection
For children with dental infections, antibiotics from the penicillin class are the most popular choice.
Your dentist may decide that additional supplemental antibiotics such as metronidazole may be needed if the infection is caused by anaerobic bacteriabacteria that don’t require oxygen and are most commonly found in the gastrointestinal tract.
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When Might Antibiotics Be Necessary
Overall, tooth extractions are straightforward and safe treatments however, there are certain circumstances in which you may be put at a higher risk of developing an infection. If you have an underlying medical condition that increases your risk of infection, you will need to take antibiotics leading up to your procedure and after it. If you have any of the following conditions, ensure that you let our dentist know before moving forward with tooth extractions:
- Congenital heart defects
- Artificial joints such as a knee replacement
- A heart condition
How To Prepare For A Tooth Extraction
Before scheduling the procedure, your dentist will take an X-ray of your tooth. Be sure to tell your dentist about any medications you take, as well as vitamins, supplements, and over-the-counter drugs.
Tell your dentist if you will soon be treated for another medical condition with an intravenous drug called a bisphosphonate. If so, the extraction should be done before the drug treatment, or your jaw could be at risk for osteonecrosis .
Also, tell your dentist about any of the following conditions:
- a congenital heart defect
- an impaired immune system
- a history of bacterial endocarditis
Your dentist may want to make sure all conditions are stable or treated before you undergo the tooth extraction. You might be prescribed antibiotics in the days leading up to the procedure if:
- your surgery is expected to be long
- you have an infection or a weakened immune system
- you have a specific medical condition
Its helpful to keep the following in mind for the day of the tooth extraction in order to ensure quality treatment:
- If you will be receiving intravenous anesthesia, wear a short-sleeved shirt or loose-fitted clothing, and dont eat or drink for six to eight hours before your appointment.
- Dont smoke beforehand.
- Tell your dentist if you have a cold, as you may need to reschedule.
- Tell your dentist if you had nausea or vomiting the night before, which may require different anesthesia or rescheduling.
- If youre receiving general anesthesia, have someone with you to drive you home.
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