By Lina Garcia, DMD, DDS

Recently, I came across an article in a dental magazine that challenged the use of antibiotics in dentistry.

“Antibiotics for Third Molar Extractions,” from the December 2010 edition of Dentaltown magazine, described a New Zealand research study that showed NO significant differences in post-operative pain, infections, swelling, or temperature between patients who did and did not receive antibiotics for third molar extractions. The article concluded that “the risks associated with taking antibiotics seem to outweigh the risks due to infection after extractions.”

The article has inspired me to write this commentary.

The routine use of antibiotics in dentistry (for example, prophylactically for cleanings and for pre- and post-surgical procedures) has been the standard of care for decades. It has also long been promoted by the American Dental Association (ADA).

The idea is that antibiotics will protect the patient from infections that are thought to be a direct result of bacteremia (bacteria entering the bloodstream) caused by the dental procedure. The fear is that the bacteria will spread to other parts of the body, such as the heart, and will cause other serious issues for the patient.

But bacteremia can happen at any time. Simply flossing or brushing your teeth and chewing food can expose bacteria, not just when you get dental work done.

We are constantly exposed to bacteria, even during our own home dental care, and our body is more than capable of handling the exposure. So the idea of prescribing antibiotics as a preventative measure for bacteremia is simply outrageous.

More importantly, the use of antibiotics has its own severe side effects. New research is supporting and confirming that antibiotics are causing way more harm than good, by turning the bacteria they are supposed to kill into medicine-resistant monsters. To make matters worse, there is no new antibiotic strong enough to kill these resistant bacteria.

People are getting weaker and increasingly ill as a result of the inappropriate, widespread overuse of antibiotics!

Only recently, in 2007, has the ADA updated and changed its prophylactic antibiotic protocol. The change was based on the risks associated with antibiotic use and on the total lack of scientific data supporting routine antibiotic use. Even so, there is still unnecessary overuse of antibiotics, which betrays patients’ trust and makes them vulnerable to irreversible autoimmune diseases. In my opinion, dentistry is the medical discipline most abusive of antibiotic overuse.

But we don’t need to be scared!

For 30 years I have been practicing dentistry without antibiotics. In my private practice, we use nutrition and supplements as antibiotics and anti-inflammatories, having no need to prescribe drugs for patients’ care. I also work in an oral surgery practice with two other specialists. As a standard procedure, every patient that goes through surgery – from simple extractions to complicated wisdom tooth surgery – leaves the office with an antibiotic prescription, except for the patients that are under my care.

As a result my patients recover better, without drug-induced side effects, and with no dry sockets or other symptoms.

So why the widespread use of antibiotics? FEAR by the dentists, for the most part, of being sued if something goes wrong, or simply dentists blindly following the ADA’s outdated protocols.

Drugs are not the only solution, so PLEASE think twice about filling that antibiotic prescription from your dentist.

My clinical experience has shown time and again that nutrition and supplementation are all that is needed to prevent infection and other complications from dental procedures. My patients are happier and healthier as a result of the basic healthy principles that true holistic dentistry promotes. Be well!

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References

Dentaltown. Antibiotics for Third Molar Extraction. Dentaltown, Vol. 11, Issue 12: 122, December 2010.

Siddiqi, A., Morkel, A., Zafar, S. Antibiotic Prophylaxis in Third Molar Surgery: A Randomized Double-Blind Placebo-Controlled Clinical Trial Using Split-Mouth Technique. Int J Oral Maxillofac Surg 39: 107-114, 2010.

Tong DC, Rothwell B. Antibiotic Prophylaxis in Dentistry: A review and Practice Recommendations. J Am Dent Assoc, Vol. 131, No. 3: 366-374, 2000.

Wilson W, et al. Prevention of infective endocarditis. Guidelines from the American Heart Association. A guideline from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and Outcomes Research Interdisciplinary Working Group. Circulation 2007; 116: 1736-1754.

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