New guideline recommends treatment over antibiotics for toothache

Dental Tribune International

Thu. 7. November 2019

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CHICAGO, U.S.: Action to combat the overprescription of antibiotics and the consequent development of antibiotic-resistant bacteria is desperately needed. A new guideline released by the American Dental Association (ADA) recommending that antibiotics are not needed in most cases of toothache may be the impetus needed to bring about a healthy change when it comes to the problem of overprescription. According the ADA, the move is in alignment with its commitment to the U.S. government’s Antimicrobial Resistance Challenge.

“Antibiotics are, of course, tremendously important medications,” said Dr. Peter Lockhart, chair of the ADA expert panel that developed the guideline and a research professor at Atrium Health’s Carolinas Medical Center. “However, it’s vital that we use them wisely so that they continue to be effective when absolutely needed.”

According to the ADA, healthy adult patients experiencing toothache are better served by receiving treatment. The new guideline recommends against using antibiotics for most pulpal and periapical conditions and instead recommends, if needed, over-the-counter pain relievers such as acetaminophen and ibuprofen.

“When dental treatment is not immediately available and the patient has signs and symptoms such as fever, swollen lymph nodes, or extreme tiredness, antibiotics may need to be prescribed,” said Lockhart. “But in most cases when adults have a toothache and access to dental treatment, antibiotics may actually do more harm than good.”

The guideline, titled “Evidence-based clinical practice guideline on antibiotic use for the urgent management of pulpal- and periapical-related dental pain and intraoral swelling: A report from the American Dental Association,” was published in the November 2019 issue of the Journal of the American Dental Association.

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