Supporting Your Practice

Antibiotic Considerations in Oral Surgery

CDA Oasis November 1, 2021

In the latest installment in a series of presentations on the principles of oral surgery for general practitioners, Dr. Keyvan Abbaszadeh, an oral and maxillofacial surgeon from London, Ontario, reviews the use of antibiotics in oral surgery.

Here are some key takeaways from the conversation:

94% of oral infections are caused by anaerobic or mixed (aerobic/anaerobic) bacteria. The majority of infections are initiated by aerobic bacteria with anaerobic bacteria following. The synergy between the two can cause serious infections.
Antibiotics are never a substitute for incision and drainage or other means to remove of the source of infection.

INDICATIONS FOR ANTIBIOTIC USE

Rapidly progressing infection
Diffuse tissue involvement
Compromised host immune system
Fascial space involvement
Severe pericoronitis
Osteomyelitis

CONSIDERATIONS WHEN CHOOSING AN ANTIBIOTIC

Most appropriate spectrum activity
Least adverse side effects
Least expensive option
Lowest potential drug-to-drug interaction
Proper dosage
For oral surgery, Penicillin fits most of the above criteria

WHEN ANTIBIOTIC USE MAY NOT BE NECESSARY

Localized infections
Minor abscess
Mild pericoronitis
Dry socket
Viral infection

WHEN TO REFER

There may be occasions when it is necessary to refer a patient for medical care of an infection. Indications for this scenario include:

High fever
Voice changes
Difficulty speaking, swallowing and/or opening mouth

We hope you find the conversation useful. We welcome your thoughts, questions and/or suggestions about this post and other topics. Leave a comment in the box below or send us your feedback by email.

Until next time!
CDA Oasis Team