A study published in Nature on Dec. 17, which examined 269,003 Veteran Affairs Dental patients between January 2015 and December 2019, suggests that prescribing antibiotics before dental extractions may increase complications in non-diabetic patients.
Antibiotics were more commonly prescribed for patients undergoing surgical extractions. During 122,810 visits—representing 31.8 per cent of the total 385,880 dental visits—patients received antibiotics prior to the procedure, with amoxicillin being the most frequently prescribed.
The study found that 3,387 patients experienced complications such as oral infections, dry socket, or fever within seven days of the extraction. Of those, 1,272 had received antibiotics, compared with 2,115 who had not.
The researchers noted that diabetes acted as a “statistically significant modifier of an association.” For non-diabetic patients, receiving antibiotics increased the likelihood of a post-extraction complication.
In contrast, the study concluded that among this sample of older patients, there was no overall association between being prescribed antibiotics and post-extraction complications.
Patient demographics, medical history, and details of the extractions were analyzed in the study, using multivariable logistic regression models and sensitivity analyses to exclude antibiotics prescribed by medical providers.
The use of antibiotics in dentistry is under increasing scrutiny. In 2019, the World Health Organization identified antimicrobial resistance as one of the top ten threats to global health.
According to the Royal College of Dental Surgeons of Ontario (RCDSO), dentists in Canada prescribe nearly 10 per cent of all antibiotics, despite most cases of tooth pain being manageable with dental procedures or pain medications instead of antibiotics.
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