Dentaltown June 2017 - 40
message board
Antibiotics After Surgical Extractions
A Townie asks his peers for input about what, if anything, to prescribe
breezy11
Member Since: 07/04/14
Post: 1 of 123
I know many dentists (myself included) will prescribe antibiotics after any surgical extraction,
but I'm trying to figure out if it's really the best way to go or really a CYA situation. I do a ton of
surgical extractions at my office, so I'm just wondering what some of you do in cases where all
you need to do is very minor bone removal. Do you prescribe antibiotics in those cases?
My approach has been that if it's an intensive surgical extraction, I'll put them on seven
days of amox or equivalent. If it's very minor surgical extraction, I'll drop it down to 3-4 days.
What's your approach? ■
2/16/2017
AtreidesDDS
Member Since: 02/11/11
Post: 4 of 123
I work in public health and have seen a lot of postop infections after surgical extractions.
I now routinely prescribe a short course of antibiotics for any case where I elevate a flap and
perform a surgical extraction. I also have the patient swish with CHX prior to beginning the
procedure. My incidence of postop infections has really improved. ■
2/16/2017
Eazy Breezy
Member Since: 03/08/09
Post: 5 of 123
I give antibiotics if it was an intensive surgical extraction and there was an abscess/PARL/
pus. If they've got really gross nastily inflamed pus/oozing/perio gums, they'll get antibiotics
as well. Otherwise just some Norco for surgical without pus/infection. And tell them OTC
for simple. ■
2/16/2017
Sun Tzu
Member Since: 01/24/12
Post: 12 of 123
One size doesn't fit all. The general rule of thumb is that removing the cause of infection is
the best thing you can do, but we also have to consider the possibility of wound contamination,
particularly in an environment such as the oral cavity.
I definitely find pre-rinsing with chlorhexidine (0.2%) for 60 seconds immediately prior to
an extraction does help. If you put stuff in sockets (e.g. Benacel), I find dipping it in chlorhexidine gel too also helps. I also think that wearing sterile gloves plays a part.
Apart from their medical status, also consider the general state of their mouth. Is it really
icky? Was the extraction particularly involving? Was it a lower wizzie which had a lot of pus?
Digging near the sinus for a while? Think about where infections can spread. ■
2/18/2017
Retimo
Member Since: 02/23/12
Post: 13 of 123
I think there's a lot of pushback against over prescribing antibiotics, especially lately in the
literature and JADA. I stick to not prescribing unless there is pus, swelling, fever or trismus. One
other time might be with a patient who has symptomatic apical perio and necrotic pulp but you
can't address that day with a pulpectomy or ext. (There was an article in JADA less than a year
ago chastising IMO dentists for giving antibiotics for irreversible pulpitis)
Although I most often don't give oral antibiotics for surgical extractions, I do usually place
resorbable hemostatic gauze generously dusted with doxycycline. There are studies that show
topical antibiotics placed in sites after third molar extraction have reduced postop complications, especially dry socket. ■
2/18/2017
40
JUNE 2017 // dentaltown.com
http://www.dentaltown.com/MessageBoard/thread.aspx?a=11&s=2&f=173&t=287170&g=1&st=Antibiotics%20After%20Surgical%20Extraction
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Table of Contents for the Digital Edition of Dentaltown June 2017
On dentaltown.com
Howard Speaks: Drive-Thrus and Dentistry
Professional Courtesy: Planning Ahead
Continuing Education Update
Travel and Learn: Live Ce Events
Industry News
Poll
Message Boards: Rubber Dam Frustrations? Tips and Tricks?
Message Boards: Why So Hard to Make a Good Rpd Framework
Message Boards: Antibiotics After Surgical Extraction
Message Boards: How to Know When Asymptomatic Apical Lesions Need Re-Treats?
Women in Dentistry: (Private) Practice Makes Perfect
Women in Dentistry: Forward Momentum
A Guaranteed Win in Vegas
Laser Education: Science and Safety
What's Your M.o?
Strength in Numbers
Product Profile: Premier
Product Profile: Smartbox Web Marketing
Product Profile: Dentsply Sirona Endodontics
Ad Index
Untangling Web Marketing
Ce: Understanding Survivors of Childhood Abuse
Dentally Incorrect
Dentaltown June 2017 - Intro
Dentaltown June 2017 - Cover1
Dentaltown June 2017 - Cover2
Dentaltown June 2017 - 1
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Dentaltown June 2017 - 5
Dentaltown June 2017 - 6
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Dentaltown June 2017 - On dentaltown.com
Dentaltown June 2017 - 9
Dentaltown June 2017 - Howard Speaks: Drive-Thrus and Dentistry
Dentaltown June 2017 - 11
Dentaltown June 2017 - 12
Dentaltown June 2017 - 13
Dentaltown June 2017 - Professional Courtesy: Planning Ahead
Dentaltown June 2017 - 15
Dentaltown June 2017 - Continuing Education Update
Dentaltown June 2017 - 17
Dentaltown June 2017 - 18
Dentaltown June 2017 - 19
Dentaltown June 2017 - Travel and Learn: Live Ce Events
Dentaltown June 2017 - 21
Dentaltown June 2017 - Industry News
Dentaltown June 2017 - 23
Dentaltown June 2017 - 24
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Dentaltown June 2017 - Poll
Dentaltown June 2017 - 27
Dentaltown June 2017 - Message Boards: Rubber Dam Frustrations? Tips and Tricks?
Dentaltown June 2017 - 29
Dentaltown June 2017 - 30
Dentaltown June 2017 - 31
Dentaltown June 2017 - 32
Dentaltown June 2017 - 33
Dentaltown June 2017 - Message Boards: Why So Hard to Make a Good Rpd Framework
Dentaltown June 2017 - 35
Dentaltown June 2017 - 36
Dentaltown June 2017 - 37
Dentaltown June 2017 - 38
Dentaltown June 2017 - 39
Dentaltown June 2017 - Message Boards: Antibiotics After Surgical Extraction
Dentaltown June 2017 - 41
Dentaltown June 2017 - 42
Dentaltown June 2017 - 43
Dentaltown June 2017 - 44
Dentaltown June 2017 - 45
Dentaltown June 2017 - Message Boards: How to Know When Asymptomatic Apical Lesions Need Re-Treats?
Dentaltown June 2017 - 47
Dentaltown June 2017 - 48
Dentaltown June 2017 - 49
Dentaltown June 2017 - Women in Dentistry: (Private) Practice Makes Perfect
Dentaltown June 2017 - 51
Dentaltown June 2017 - 52
Dentaltown June 2017 - 53
Dentaltown June 2017 - 54
Dentaltown June 2017 - Women in Dentistry: Forward Momentum
Dentaltown June 2017 - 56
Dentaltown June 2017 - 57
Dentaltown June 2017 - A Guaranteed Win in Vegas
Dentaltown June 2017 - 59
Dentaltown June 2017 - 60
Dentaltown June 2017 - 61
Dentaltown June 2017 - Laser Education: Science and Safety
Dentaltown June 2017 - 63
Dentaltown June 2017 - 64
Dentaltown June 2017 - 65
Dentaltown June 2017 - 66
Dentaltown June 2017 - 67
Dentaltown June 2017 - What's Your M.o?
Dentaltown June 2017 - 69
Dentaltown June 2017 - 70
Dentaltown June 2017 - 71
Dentaltown June 2017 - 72
Dentaltown June 2017 - 73
Dentaltown June 2017 - Strength in Numbers
Dentaltown June 2017 - 75
Dentaltown June 2017 - 76
Dentaltown June 2017 - Product Profile: Premier
Dentaltown June 2017 - Product Profile: Smartbox Web Marketing
Dentaltown June 2017 - 79
Dentaltown June 2017 - Product Profile: Dentsply Sirona Endodontics
Dentaltown June 2017 - Ad Index
Dentaltown June 2017 - Untangling Web Marketing
Dentaltown June 2017 - 83
Dentaltown June 2017 - 84
Dentaltown June 2017 - 85
Dentaltown June 2017 - 86
Dentaltown June 2017 - 87
Dentaltown June 2017 - Ce: Understanding Survivors of Childhood Abuse
Dentaltown June 2017 - 89
Dentaltown June 2017 - 90
Dentaltown June 2017 - 91
Dentaltown June 2017 - 92
Dentaltown June 2017 - 93
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Dentaltown June 2017 - Dentally Incorrect
Dentaltown June 2017 - Cover3
Dentaltown June 2017 - Cover4
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