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. 2016 Jan 1;21(1):e82-7.
doi: 10.4317/medoral.20669.

Survey of Spanish dentists on the prescription of antibiotics and antiseptics in surgery for impacted lower third molars

María-Iciar Arteagoitia  1 , Eva Ramos, Gorka Santamaría, Julio Álvarez, Luis Barbier, Joseba Santamaría
Affiliations

Survey of Spanish dentists on the prescription of antibiotics and antiseptics in surgery for impacted lower third molars

María-Iciar Arteagoitia et al. Med Oral Patol Oral Cir Bucal. .

Abstract

Background: This study explored the attitude of registered dentists in Biscay towards prescribing antibiotics and/or antiseptics to prevent potential infections after surgical extraction of completely bone-impacted third molars in otherwise healthy individuals, with no history of infection.

Material and method: We sent letters to 931 registered dentists in Biscay, with an explanation of the study objectives, description of a case of lower third molar impaction, including a panoramic radiograph, and a questionnaire. The questionnaire asked whether they would prescribe antibiotics and/or antiseptics, in the hypothetical case of lower third molar extraction surgery presented, and if so, when, what type, at what dose and how long for.

Results: The questionnaire was completed by 261 dentists (28%), with a mean age of 44.3 years old (SD 11.05) and mean of 18.7 years working as a dentist (SD 9). A total of 216 dentists (82.7%) considered it necessary to prescribe antibiotics. Of these, 126 (58.3%) would prescribe amoxicillin and 74 (34.5%) amoxicillin/clavulanic acid, while 129 dentists (59%) would prescribe antibiotics both before and after surgery and 10 (4.6%) only after surgery. The most common doses were amoxicillin 500 mg or 750 mg every 8 hours, and amoxicillin/clavulanic acid 875/125 mg every 8 hours, in both cases for a mean of 7 days. Further, 74 dentists (28%) said they would use immediate post-extraction socket irrigation with chlorhexidine, while 211 (81%) would prescribe antiseptics in the postoperative period, of whom 97% recommended chlorhexidine. We did not find significant differences in the use of antibiotics or antiseptics by dentist age (ANOVA p=0.22 and p=0.53, respectively), or professional experience (ANOVA p=0.45 and p=0.62).

Conclusions: In our sample, the prophylactic prescription of antibiotics and/or chlorhexidine is widespread in clinical practice, in most cases amoxicillin and amoxicillin/clavulanic acid for a week, starting the treatment before surgery.

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Conflict of interest statement

Conflict of interest statement: The authors have declared that no conflict of interest exist.

Figures

Figure 1
Figure 1
Panoramic radiograph showing an impacted lower third molar completely covered in bone, the tooth indicated for extraction in the case described in the survey.
Figure 2
Figure 2
Types of antibiotics that would be prescribed for extraction of completely bone-impacted third molar, by percentage of respondents.
Figure 3
Figure 3
Antibiotic regimens with amoxicillin (a,b) and amoxicillin/clavulanic acid (c,d).
See this image and copyright information in PMC

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