Are Antibiotics Required For Implants?
Use of antibiotics should be judicious and carefully thought out. Just because you have an “infection” in your tooth, it does not mean you need an antibiotic. Also, not all “infections” are actually infections. Not all infections can be cured by antibiotics alone.
In fact if you are allergic to penicillin please click this link. Being allergic to penicillin carries more risk for implants and bone grafting.
Antibiotics are commonly needed for procedures that involved cutting through bone or addition of bone graft materials. There is a limited supply of new blood vessels that can get your natural immune system’s protection in the first few days following a significant procedures such as a surgical extraction, a bone graft, sinus graft, apicoectomy and dental implants.
Antibiotics are extremely helpful in many situations. I also discuss common questions such as antibiotic resistance and what happens with common stomach issues and what to do about them.
I think you will find this video helpful. Please feel free to ask questions below.
Ramsey A. Amin, D.D.S.
Diplomate of the American Board of Oral Implantology /Implant Dentistry
Fellow-American Academy of Implant Dentistry
Video Transcription Antibiotics for Implants:
Hello Ramsey Amin, DDS here. Antibiotics are always a big topic of discussion and can antibiotics help my tooth? Do I need antibiotics before an extraction, after an extraction, before a bone graft, after a bone graft? There’s so many different times that we may need the benefit of antibiotics and perhaps sometimes we do not. Most often I receive a question online about a failing tooth that you were told is infected and needs to be removed. And a question arises, well, should I be on antibiotics? Most infections that are within teeth are oftentimes at the apex or the end of the root. They are oftentimes around a root canal tooth that is treatment plan for extraction because it’s fractured or a crown can not be made for it. And these infections, quote unquote, or inflammation are chronic in nature typically.
If your face isn’t swollen, there’s no pus draining, you don’t have a limited opening, a bad taste in your mouth, a fever, chills, night sweats. Most of the time antibiotics are not necessary until the tooth is removed and especially if a bone graft or a dental implant is placed at the same time. The antibiotics can be placed either in the IV, during IV sedation or taken orally by mouth as pills. But antibiotics are not a cure all. They do help to reduce bacterial counts and reduce infections that can occur. Infections can and do occur and just because you are on an antibiotic doesn’t mean that you will not get an infection. Most antibiotics have some degree of what we call broad spectrum nature where they do kill some bacteria of all different types. Amoxicillin and perhaps clindamycin are the most common. There are others such as augmentin, and Z packs, and other very strong medications such as metronidazole, flagyl, vancomycin ,that are not always necessary.
Some infections do get, or can get out of hand, depends on your own immune system. Other factors, do you take medications that can impair your immune system? Do you have HIV? There are many things that can cause antibiotics not to work and infections to get worse. If an infection gets worse, oftentimes the entire family of antibiotic needs to be switched from the amoxicillin, penicillin family to a clindamycin family perhaps, or what’s called a culture and sensitivity is done in order to determine, well, what kind of bacteria are here? Do we need to determined by a microbiological culture, basically some and grow them in a Petri dish and expose them to different antibiotics and see which one works best against this infection.
But antibiotics are needed for some patients. They do have side effects of course. They should be used conservatively, not too liberally. And they can also cause issues within the gut. Oftentimes a dose of probiotics or just simple daily four ounces of yogurt with acidophilus can help reduce the chance of getting a upset stomach from antibiotics. Antibiotics are always absorbed better with food than without food typically. But just keep in mind the antibiotics are not always needed. Your dentist is all ultimately going to tell you whether you need them or not and just be sure to follow through on schedule all the way through until they’re complete if you are placed on an antibiotic.
Sometimes only a preoperative antibiotic is needed, just a single dose at the beginning of an implant or a bone graft surgery. That’s typically done by IV in the IV sedation in the arm. A dose of antibiotics can be given then and sometimes there is not need for followup, but again, they are not always necessary on all extractions. Definitely on larger bone grafts and multiple implants. Even most single implants will require antibiotic therapy. They do not cure failing apicoectomy teeth or failing root canal teeth. They simply provide a patch or a temporary bandaid for seven to 21 days, perhaps, until definitive treatment can be done and it be taken care of. Thank you so much for watching.