Indications for use of antibiotic prophylaxis in dental practice: In order to prevent further development of bacterial resistance to antibiotics the Danish Health and Medicines Authority has requested professional guidelines describing proper clinical use of antibiotics. This article deals with the basis for administration of prophylactic antibiotics in dentistry.
Indications exist in patients at risk of developing local or general infectious disease due to either severe general immunosuppression or locally increased susceptibility (locus minoris resistentiae) and in otherwise healthy patients undergoing extensive invasive procedures in the oral cavity. However, a number of medical diseases and therapies causing minor immunosuppression and performing of less extensive oral treatment does not pose an indication for antibiotic prophylaxis. The decision must always be based on a thorough evaluation of the patient’s medical and oral risk factors.
When prophylaxis is indicated a single dose of amoxicillin (2 g) (clindamycin/roxithromycin if the patient is allergic to penicillins), is administered per os one hour before treatment. Furthermore, it is of the utmost importance to maintain healthy oral and periodontal conditions in patients at risk in order to reduce the incidence of bacteremia and systemic dissemination of oral microorganisms during tooth brushing and other daily activities.