This review of whether metronidazole used as monotherapy or in addition to a β-lactam antibiotic offers any additional benefit over β-lactam monotherapy in non- periodontal dental infections includes 3 RCTs. The findings suggest that metronidazole does not provide superior clinical results compared to β-lactam antibiotics for the treatment of non-periodontal dental infections. However the evidence is limited and of low quality.
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This Cochrane review update of antibiotic prophylaxis before invasive dental procedures in people at risk or at high risk of bacterial endocarditis included one case-controlled study. Consequently, there is no clear evidence about whether antibiotic prophylaxis is effective or ineffective against bacterial endocarditis in at-risk people who are about to undergo an invasive dental procedure.
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This new guideline from the American Dental Association is about the the appropriate use of systemic antibiotics for the urgent management of symptomatic irreversible pulpitis with or without symptomatic apical pulpitis, pulp necrosis and symptomatic apical periodontitis and pulp necrosis and localized acute apical abscess.
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Only 2 RCTs are included in this Cochrane review update of the effects of systemic antibiotics on adults with symptomatic apical periodontitis or acute apical abscess providing insufficient evidence of effectiveness.
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This review of antibiotic prophylaxis for the removal of third molars included 22 RCTs and suggest that antibiotic use lowered the infection risk by 60%. The number pf patients needed to treat to prevent one infection was 14 (95%CI;11-19).
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10 RCTs were included in this review of preoperative antibiotics for removal of third molars. The use of antibiotics significantly reduced the odds of surgical site infection or alveolar osteitis (OR = 0.30; 95% CI, 0.19 to 0.47; P≤.00001)
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The recommended treatment for apical periodontitis or acute apical abscess is removal of the source of inflammation or infection by local, operative measures ie tooth extraction or pulp extirpation possibly in combination with the incision and drainage of any swelling present. Antibiotics are only recommended where there is evidence of spreading infection or systemic symptoms. [read the full story…]
Sinusitis is one of the commonest reasons for visiting the doctor accounting for 15% to 21% of all adult outpatient antibiotic prescriptions. Patients may also present at dental practices, as pain from upper posterior teeth can be indistinguishable from sinusitis. Typical signs and symptoms are purulent nasal discharge, postnasal drip, sinus pain at palpation, nasal [read the full story…]
Irreversible pulpitis often presents as an acute and intense pain and is a frequent reason for emergency dental visits. Treatment involves accessing the root canal of the tooth to remove the inflamed pulp (nerve) and cleaning the root canal. The aim of this review was to assess the effects of systemic antibiotics for irreversible pulpitis. [read the full story…]
