Dentists, emergency room
doctors and primary care physicians need to ease up on prescribing antibiotics
for dental issues in patients who are otherwise healthy and have no
manifestation of systemic disease.
That’s according to an
American Dental Association clinical practice guideline co-authored by a
researcher at the Case Western Reserve University School of Dental Medicine.
The study, published as the cover story in TheJournal of the American Dental Association, concluded that antibiotics should only be used for systemic issues, such as fever and swelling, when an infection is clearly present and worsening. It also advises patients receive dental treatment instead and manage pain with over-the-counter pain medications.
“Antibiotics shouldn’t be the first line of defense for dental pain and swelling,” said Anita Aminoshariae, director of the dental school’s endodontics program.
Aminoshariae was part of a panel
consisting of dentists, endodontists, physicians and pharmacists that set out
to formulate recommendations to assist clinicians and patients in determining
the appropriate use of systemic antibiotics for the urgent management of tooth
pain and swelling. The results of the study suggested that ”antibiotics may
provide negligible benefits” at best.
“What we’re trying to avoid
is a patient coming to an urgent care facility with tooth pain, hot/cold
sensitivity and walking out with a regimen of antibiotics,” Aminoshariae said. “One
of our main objectives here is to get this information to the public so that
the patient may be referred to a dentist and receive the appropriate dental
Scientists have long known
that the inappropriate use of antibiotics can do more harm than good, and can
contribute to issues like antibiotic resistance. Unfortunately, research into appropriate
antibiotic prescribing is relatively new territory.
As part of the systematic
review and guideline development process, the ADA outlined five new clinical
recommendations and two practice statements, all related to prescribing
antibiotics to patients with dental issues when a dental office setting is and
is not available.
“This is about having some best practices in place,” Aminoshariae said, “and what we know is that there are too many dentists and physicians giving patients antibiotics when the patients just do not need them.”