Antibiotics to prevent complications following tooth extractions

Lodi, Giovanni; Figini, Lara; Sardella, Andrea; Carrassi, Antonio; Fabbro, Massimo Del; Furness, Susan

doi:10.1002/14651858.cd003811.pub2

Cited by 143 publications

(82 citation statements)

References 74 publications

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“…Aunque se cree que su uso podría prevenir la aparición de infecciones y de alveolitis seca, diversos autores reportan que no es necesario el uso de antibióticos como profilácticos 2,8,46,47 . Su uso no está recomendado a menos que el paciente esté inmunocomprometido o si existiera el riesgo de desarrollar osteomielitis 8,47 .…”

Section: Antibióticosunclassified

Alveolitis seca: una revisión de la literatura

Vergara‐Buenaventura

2014

Revista Española de Cirugía Oral y Maxilofacial

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información del artículo Historia del artículo: Recibido el 17 de febrero de 2014 Aceptado el 11 de abril de 2014 On-line el 23 de octubre de 2014 Palabras clave: Alvéolo seco Alveolagia Osteítis alveolar r e s u m e nLa alveolitis seca es la complicación posoperatoria más frecuente como resultado de la alteración en la cicatrización de la herida alveolar después de una extracción dental. El manejo de esta afección tiene por objetivo el control del dolor durante el periodo de curación del cuadro, lo cual se logra fundamentalmente mediante medidas paliativas.El objetivo de esta revisión de la literatura es obtener suficiente información sobre las causas y otros factores que podrían estar involucrados en esta complicación postoperatoria, así como las opciones de tratamiento que existen actualmente. a b s t r a c tDry socket is the most common postoperative complication, due to problems in alveolar wound healing after tooth extraction. The management of this condition aims to control pain during the healing period, and is mainly achieved with palliative drugs.The aim of this literature review is to obtain sufficient information on the causes and any other factors that could be involved in this post-operative complication, as well as the currently available treatment options. IntroducciónLa alveolitis seca es la complicación postoperatoria más frecuente después de una extracción dental 1 , con una frecuencia de aparición comúnmente entre el 1 al 5% 2,3 , aunque existen reportes de hasta un incidencia del 70% 4 de los pacientes en la práctica dental. Se ha aceptado que la alveolitis tiene una etiología multifactorial (sistémica y local) 5 , lo que a su Correo electrónico: avergarab@outlook.com vez ha producido que se enumeren diferentes opciones de tratamiento 6 . Actualmente el manejo de la alveolitis está enfocado a aliviar la sintomatología que refiere el paciente, mediante el uso de agentes paliativos, enjuagues 7 e incluso fármacos. Sin embargo, hasta el momento no existe un consenso establecido para su manejo, pues su exacta patogénesis ha sido aún poco estudiada 8,9 .

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Section: Antibióticosunclassified

Alveolitis seca: una revisión de la literatura

Vergara‐Buenaventura

2014

Revista Española de Cirugía Oral y Maxilofacial

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“…Our results in a VA clinic identified that while 87.3% of antibiotics were indicated, 91.8% of antibiotics prescribed for infection prophylaxis were inconsistent with recommendations. In our study, postprocedure antibiotic prophylaxis was administered for the majority of patients undergoing tooth extraction or implant surgery despite evidence supporting administering antibiotics preprocedure only [8, 13, 17, 18]. Postprocedure antibiotics used in this setting were prescribed for an extended duration (mean, 7.2 days for an excess of 824 days in the cohort), for which evidence is lacking.…”

Section: Discussionmentioning

confidence: 99%

“…Finally, national guidelines for dental procedure antibiotic prophylaxis are lacking in the absence of comorbidities (ie, cardiac conditions, prosthetic joints). However, a systematic review by the Cochrane Collaboration on the use of antibiotics for infection prophylaxis following tooth extractions found that antibiotics reduced the risk of infection, but also increased the risk of adverse events [17]. The authors concluded that due to the risk of adverse events and resistant bacteria, clinicians should carefully consider treating healthy patients with postprocedural prophylactic antibiotics [17].…”

Section: Discussionmentioning

confidence: 99%

“…However, a systematic review by the Cochrane Collaboration on the use of antibiotics for infection prophylaxis following tooth extractions found that antibiotics reduced the risk of infection, but also increased the risk of adverse events [17]. The authors concluded that due to the risk of adverse events and resistant bacteria, clinicians should carefully consider treating healthy patients with postprocedural prophylactic antibiotics [17]. A second Cochrane review evaluating the role of antibiotics at the time of dental implant placement in preventing complications found that participants receiving antibiotics were less likely to experience implant failure compared with participants not receiving antibiotics, with a number needed to treat of 25 [18].…”

Section: Discussionmentioning

confidence: 99%

“…In the absence of national guidelines, systematic reviews by the Cochrane Collaboration were used to formulate the definition for appropriateness of antibiotic prescribing for tooth extraction and implant placement [17, 18]. Regardless of the patient’s history of cardiac conditions or prosthetic joint implant, preprocedural antibiotic prophylaxis was considered appropriate administered 1 hour prior to tooth extraction and implant placement (without postprocedure antibiotic prophylaxis) [18].…”

Section: Methodsmentioning

confidence: 99%

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Use of Antibiotic Prophylaxis for Tooth Extractions, Dental Implants, and Periodontal Surgical Procedures

Suda

Henschel

Patel

et al. 2017

Open Forum Infectious Diseases

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BackgroundGuidelines for antibiotics prior to dental procedures for patients with specific cardiac conditions and prosthetic joints have changed, reducing indications for antibiotic prophylaxis. In addition to guidelines focused on patient comorbidities, systematic reviews specific to dental extractions and implants support preprocedure antibiotics for all patients. However, data on dentist adherence to these recommendations are scarce.MethodsThis was a cross-sectional study of veterans undergoing tooth extractions, dental implants, and periodontal procedures. Patients receiving antibiotics for oral or nonoral infections were excluded. Data were collected through manual review of the health record.ResultsOf 183 veterans (mean age, 62 years; 94.5% male) undergoing the included procedures, 82.5% received antibiotic prophylaxis (mean duration, 7.1 ± 1.6 days). Amoxicillin (71.3% of antibiotics) and clindamycin (23.8%) were prescribed most frequently; 44.7% of patients prescribed clindamycin were not labeled as penicillin allergic. Of those who received prophylaxis, 92.1% received postprocedure antibiotics only, 2.6% received preprocedural antibiotics only, and 5.3% received pre- and postprocedure antibiotics. When prophylaxis was indicated, 87.3% of patients received an antibiotic. However, 84.9% received postprocedure antibiotics when preprocedure administration was indicated. While the majority of antibiotics were indicated, only 8.2% of patients received antibiotics appropriately. The primary reason was secondary to prolonged duration. Three months postprocedure, there were no occurrences of Clostridium difficile infection, infective endocarditis, prosthetic joint infections, or postprocedure oral infections.ConclusionThe majority of patients undergoing a dental procedure received antibiotic prophylaxis as indicated. Although patients for whom antibiotic prophylaxis was indicated should have received a single preprocedure dose, most antibiotics were prescribed postprocedure. Dental stewardship efforts should ensure appropriate antibiotic timing, indication, and duration.

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Association of Opioid Prescriptions From Dental Clinicians for US Adolescents and Young Adults With Subsequent Opioid Use and Abuse

et al. 2019

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IMPORTANCE Through prescription writing, dental clinicians are a potential source of initial opioid exposure and subsequent abuse for adolescents and young adults. OBJECTIVE To examine the association between index dental opioid prescriptions from dental clinicians for opioid-naive adolescents and young adults in 2015 and new persistent use and subsequent diagnoses of abuse in this population. DESIGN, SETTING, AND PARTICIPANTS This retrospective cohort study examined outpatient opioid prescriptions for patients aged 16 to 25 years in the Optum Research Database in 2015. Prescriptions were linked by National Provider Identifier number to a clinician category. EXPOSURES Individuals were included in the index dental opioid (opioid-exposed) cohort if they filled an opioid prescription from a dental clinician in 2015, had continuous health plan coverage and no record of opioid prescriptions for 12 months before receiving the prescription, and had 12 months of health plan coverage after receiving the prescription. Two age-and sex-matched opioid-nonexposed control individuals were selected for each opioid-exposed individual and were assigned a corresponding phantom prescription date. MAIN OUTCOMES AND MEASURES Receipt of an opioid prescription within 90 to 365 days, a health care encounter diagnosis associated with opioid abuse within 365 days, and all-cause mortality within 365 days of the index opioid or phantom prescription date. RESULTS Among 754 002 individuals with continuous enrollment in 2015, 97 462 patients (12.9%) received 1 or more opioid prescriptions, of whom 29 791 (30.6%) received prescriptions supplied by a dental clinician. The opioid-exposed cohort included 14 888 participants (7882 women [52.9%], 11 273 white [75.7%], with mean [SD] age, 21.8 [2.4] years), and the randomly selected opioid-nonexposed cohort included 29 776 participants (15 764 women [52.9%], 20 078 [67.4%] white, with mean [SD] age, 21.8 [2.4] years). Among the 14 888 individuals in the index dental opioid cohort, 1021 (6.9%) received another opioid prescription 90 to 365 days later compared with 30 of 29 776 (0.1%) opioid-nonexposed controls (adjusted absolute risk difference, 6.8%; 95% CI, 6.3%-7.2%), and 866 opioid-exposed individuals (5.8%) experienced 1 or more subsequent health care encounters with an opioid abuse-related diagnosis compared with 115 opioid-nonexposed controls (0.4%) (adjusted absolute risk difference, 5.3%; 95% CI, 5.0%-5.7%). There was only 1 death in each cohort. CONCLUSIONS AND RELEVANCE The findings suggest that a substantial proportion of adolescents and young adults are exposed to opioids through dental clinicians. Use of these prescriptions may be associated with an increased risk of subsequent opioid use and abuse.

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Antibiotics to prevent complications following tooth extractions

Cited by 143 publications

References 74 publications

Alveolitis seca: una revisión de la literatura

Alveolitis seca: una revisión de la literatura

Use of Antibiotic Prophylaxis for Tooth Extractions, Dental Implants, and Periodontal Surgical Procedures

Association of Opioid Prescriptions From Dental Clinicians for US Adolescents and Young Adults With Subsequent Opioid Use and Abuse

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