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Treatment of acute dental infections

ABSTRACT

Oversigtsartikel Dato: 27.02.2019

Antimicrobial resistance is globally a growing public health threat. Constrained and appropriately targeted use of antibiotics in health care could slow down the development of antibiotic resistance. Dentists are responsible for a substantial proportion of all antibiotic prescriptions, thus it is important that dentists know optimal principles and practices of using antibiotics. In Nordic countries, national guidelines have an important role as a source of up to date knowledge and expert opinion on treatment of dental infections including the use of antibiotics. The Nordic guidelines highlight that antibiotics should be prescribed only with strict indications and the use of broad-spectrum antibiotics should be avoided. At the same time, it should be kept in mind that common, localised dental infections may occasionally develop into severe life-threatening infections. Whenever antibiotic treatment is considered in addition to surgical drainage it should be started an hour before the procedure to avoid spread of the infection when manipulating infected tissues. It is essential that dentists can identify the patients with systemic infection or increased infection risk. Antibiotics are needed in severe infections and for patients with increased risk of infection complications, but primarily, acute dental infections are always treated by efficient drainage and elimination of the infection focus.

Clinical relevance
Localised dental infections are primarily treated by drainage and elimination of the infection focus. In addition, antibiotics are needed in systemic or spreading infections. Because dental infections may occasionally develop into systemic, life-threatening infections, it is important that dentists can identify patients that need antibiotics and/ or referral to hospital. Knowledge on good practices in the use of antibiotics is important as increasing antibiotic drug resistance is a global health threat. It is important that dentists follow the general principles in antibiotic use in medicine and take part in the fight against antibiotic resistance in their community.