Antibiotic therapy for dental treatment should conform to the principles intended to minimise the development of antibiotic resistant bacteria. Before prescribing an antibiotic, there should be a clear indication, based on clinical and sometimes laboratory evidence, that a bacterial infection is present.

Acute dental infections are often painful and include alveolar abscesses, tooth impaction and eruption infections, acute necrotising gingival infections and necrotising eruption flap infections. These infections are all able to cause substantial, and sometimes serious, systemic effects. The treatment of these acute infections requires drainage and removal of the source of the infection. When clinically indicated, surgical treatment can be supported by antibiotics.

Long-term dental infection is often asymptomatic. These infections may involve soft or hard tissue and can cause considerable loss of tissue. Again, treatment is mainly surgical, occasionally supported by antibiotic therapy, especially if the infection becomes acute.

When selecting an appropriate antibiotic, dentists should refer to a suitable Australian source of information.1,2

 

Ken Harvey

School of Public Health, La Trobe University, Melbourne

Susie Rogers

Inner South East Melbourne Division of General Practice

Libby Roughead

School of Pharmacy, University of South Australia, Adelaide