Evaluation of the Need for Antibiotic Prophylaxis During Routine Intra-alveolar Dental Extractions in Healthy Patients: A Randomized Double-Blind Controlled Trial

Abstract

Objective: The aim of this randomized double-blind controlled trial was to evaluate the role of antibiotics in the perioperative period of dental extractions in healthy patients.

Methods: The study population included patients visiting the outpatient department of our institute. Four hundred patients were selected and randomly divided into 4 groups and underwent routine dental extraction. In group A, patients were prescribed only anti-inflammatory drugs in the postoperative period. In group B, patients were prescribed antibiotics for 3 days and concomitant anti-inflammatory drugs in the postoperative period only. In group C, patients were prescribed a single dose of antibiotic 1 hour before the extraction procedure with no postoperative antibiotics, and only anti-inflammatory drugs were prescribed in the postoperative period. In group D, patients were prescribed mouthwash starting 15 minutes before the procedure and continuing twice daily for a period of 7 days along with anti-inflammatory drugs in the postoperative period. Patients were asked to follow up on the seventh postoperative day for suture removal and were evaluated for pain, swelling, dry socket, and local signs of infection. The study was approved by the Internal Ethics Review Committee of the institute.

Results: No significant differences were seen among the groups with respect to pain (χ² [1, N = 171] = 4.939, P = .552), swelling (χ² [1, N = 171] = 10.048, P = .347), or postextraction complications.

Conclusions: Prophylactic antibiotics are not required during routine dental extractions in healthy patients. The use of antibiotic therapy without appropriate indications can result in the development of resistant organisms. However, a clear trend is seen in which practitioners overprescribe antibiotics as well as medications in general. The current evidence questions the benefits of prophylactic antibiotic therapy for patients undergoing dental extractions. In our opinion, there is no justification for routine antibiotic prophylaxis for dental extractions in healthy patients.

Keywords: Antibiotic misuse; Antibiotics; Dental extraction.