Antibiotics and toothache

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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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Third molar removal: antibiotics reduced risk of dry socket

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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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Third molars: single dose of preoperative antibiotic reduced infection

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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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Insufficient evidence to determine the effect of systemic antibiotics on adults with symptomatic apical periodontitis or acute apical abscess

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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…]

Review finds only a small benefit from antibiotic use in patients with acute sinusitis

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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…]

Currently insufficient evidence to decide if antibiotics are effective in treating irreversible pulpitis

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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…]