Prophylactic use of penicillin V in teeth with necrotic pulps and asymptomatic periapical radiolucencies

Are antibiotics being used appropriately for emergency dental treatment?

“…3 However systemic antibiotics should be used with restraint because of the possibility of allergic reactions, toxicity, side effects and the development of resistant strains of microbes. 4 In 1996 Thomas et al, investigated the prescribing of antibiotics to emergency dental patients by primary healthcare workers. 5 They concluded that both general medical and general dental practitioners had prescribed antibiotics inappropriately to patients with dental emergencies.…”

Efficacy of Prophylactic use of Antibiotics to Avoid Flare up During Root Canal Treatment of Nonvital Teeth: A Randomized Clinical Trial

“…The patients were instructed to complete a pain and swelling questionnaire for two days after the treatment. They found that the incidence of flare up was 6% in penicillin group and 24% in the control group [9]. Torabinejad et al, in randomized control trial supported the use of penicillin and erythromycin in controlling flare ups after root canal instrumentation and before obturation [17].…”

“…Some researchers recommended the systemic use of antibiotics to prevent flare up during or after root canal treatment [9,10]. Penicillin and amoxicillin, having capacity of being absorbed quickly, are drugs of choice for this purpose but many patients having allergy to these medicines cannot take them.…”

Antibiotic Resistance – A Concern for Dentists?

“…Few authors support prescription of antibiotics for routine endodontic treatment to prevent flare-ups. 8 On the contrary, others argue that certain immunological factors may be involved in a chronic, pre-existing lesion; flare-ups may be manifestations of multifactorial mechanisms, and antibiotics therefore may only be partially effective. 9 Mata et al suggests that many factors may be etiologically involved in the production of pain and swelling following endodontic therapy.…”

“…9 Mata et al suggests that many factors may be etiologically involved in the production of pain and swelling following endodontic therapy. 8 For instance, entrance of oxygen into the root canal during access may induce facultative aerobic bacteria to proliferate and produce inflammatory agents. Instrumentation and the air syringe can force bacteria into the canal and perhaps through the apical foramen.…”