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Antibiotics in dentistry – an update Robin A Seymour Dental Update 2024 40:4, 707-709.
Authors
Robin ASeymour
BDS, FDS RCS, FDS RCS(Edin), PhD, FHKAMS
Dean of Dentistry and Professor of Restorative Dentistry, School of Dental Sciences, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4BW, UK
This review article considers the changes in antibiotic usage over the past 40 years. Perhaps the most significant advance is in the prophylactic use of these drugs to reduce the effect of dentally induced bacteraemia. A greater understanding of various dental infections and, in particular, the role of bacteria in the pathogenesis of periodontal disease, has led to further interest in the indications for these drugs as adjunctive measures. Whilst new indications for the use of antibiotics become more widespread, all members of the healthcare professions need to be aware that these drugs have significant adverse effects and their misuse can lead to life-threatening infection.
Clinical Relevance: Antibiotics have revolutionized the control of infectious diseases and have a significant role in dental practice. Dentists should be fully appraised of the benefits of these drugs and when they should be prescribed. Antibiotics usage should not be a substitute for interventional procedures, such as drainage of pus or removal of sources of infection. Indications for the use of these drugs as prophylactic measures are now reducing.
Article
In 1973, the first edition of Dental Update published an article on antibiotics.1 The authors considered three main indications for the use of these drugs in dentistry, notably:
This paper provides a review of current antibiotics usage in dentistry and highlights the changes in the use of these drugs over the past 40 years.
This is perhaps the most significant change that has affected dental practice over the past 40 years, especially chemoprophylaxis to prevent dental-induced procedures causing infective endocarditis in at risk patients. This topic has been the subject of much debate and controversy and, of course, great concern to dental professionals. Evidence was accumulating that penicillins (the drug of choice in dealing with dental-induced bacteraemia) afforded little or no benefit for this indication.2 Likewise, it was estimated that adverse effects from the penicillins, especially anaphylaxis, was more likely to kill the patient than if they contracted infective endocarditis.3 There was also debate over what procedures needed cover and the categories of patients at risk.
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