My Dentist Never Gave Me Antibiotics After a Tooth Extraction

Written & Reviewed by Dr David Chen

So you just got home after your tooth removal procedure and that was no joke. You made it through in one piece but the entire experience felt like one big blur. Nonetheless, it’s over and its time for you to take your medication except you just realized that your dentist never gave you antibiotics after the tooth extraction!

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Was that supposed to happen or did they simply forget? Are you wondering what you should do because you’re worried about potentially getting an infection. We’re here to help you out.

Your extraction did not require antibiotics

Your dentist didn’t give you any antibiotics because your tooth removal did not require any. Yes, you read that correctly. You weren’t prescribed any because it was unnecessary for your tooth’s condition.

You may be surprised but most routine teeth extractions do not require any antibiotics. If the tooth had a large cavity and it was breaking down but there was no infection, why would you need it? If there was no bacteria to kill off then it is pointless to take it.

Tooth conditions that do not require antibiotics:

  • Routine extraction. When we say routine we mean a non-surgical extraction. The difference is that the routine one does not require drilling away bone or reflecting a gum flap. Situations which may require both of those would be an impacted wisdom tooth. Otherwise a routine tooth removal is not very invasive and do not require it.
  • Tooth decay without swelling. Even if you have a large cavity on the tooth, as long as there is no swelling present, you will not need it. Once the source of your pain (the tooth) is gone, all symptoms should resolve.
  • No abscess or pus present. A serious infection will have an abscess or have pus oozing out of the tooth. If you don’t see either, chances are you won’t need the prescription.
  • Loose tooth. A tooth that has been ravaged by gum disease can get extremely loose, loose enough to be pulled. These teeth certainly do not require taking it afterwards. Do you recall taking antibiotics every time you lost a baby tooth? Bet you don’t.

As a matter of fact, it is not a part of standard protocol to give antibiotics after every extraction. It is encouraged to not give any if the patient does not need it. Therefore antibiotics are given on an as needed basis. It’s not guaranteed that you’ll be getting a prescription for it if you’re getting a tooth taken out.

When are antibiotics needed?

The most common reasons to give antibiotics after an extraction is if there is a severe infection or the tooth needs to be surgically removed. We’ll give you a few examples of when they would be needed.

  • Diffuse swelling. Swelling in the mouth that cannot be pinpointed or localized. If your dentist can’t identify the precise source of the infection, they would be forced to prescribe it for you to ensure the infection gets eliminated.
  • Surgical extractions. Routine dental extractions do not require antibiotics but surgical extractions sure do. An example would be a severely decayed tooth that breaks down to the gum line during the procedure. Since there is no more tooth structure to grab with the forceps, your dentist is forced to start drilling away bone in order to get the tooth out. Congratulations, your routine procedure has turned into a surgical one.
  • Severe infections. Extensive dental abscesses and infections will require it with no exceptions.
  • Impacted wisdom teeth. The third molars which are partially or completely impacted within the bone will require a surgical extraction. The jaw bone must be drilled away in order to expose the tooth enough for it to be removed.
  • Sinus exposure. The roots of some upper molars or premolars can be close to the floor of the sinus. That increases the chances of a sinus perforation as a complication. If your sinus gets exposed you will need a more potent antibiotic such as Augmentin.

As you can see, all of the above situations are pretty severe when compared to the situations which do not require it.

Will I get an infection without taking it?

Certainly taking antibiotics will always decrease the risk of you getting an infection but it does not prevent it completely. There are always instances where the infection doesn’t go away even with taking it.

Therefore you can get an infection since you weren’t given any. However the chances for that are fairly low. Your dentist didn’t give you any because they weighed the risks to benefits for it. The extremely slim chance of acquiring an infection does not outweigh the potential for you to develop antibiotic resistant bacteria.

The risk for getting resistant bacteria (super bug) far outweighs a post-surgical infection from an extraction. If you happen to catch a super bug you will need to be hospitalized in order to deal with it. That is much more severe and costly to you.

The current trend is to minimize the amount of antibiotics being prescribed whenever possible. It is a collective effort to reduce the incidences of developing antibiotic resistant bacteria. The super bugs have become a huge burden on hospitals.

Takeaway

If you weren’t given antibiotics after your tooth removal, it was most likely because your condition did not require it. Usually if you didn’t have any swelling on your face or mouth, the chances are that it wasn’t infected enough to require it. In other words you’ll still recover just fine without taking any of it.

Nonetheless, if you were worried we do recommend giving your dentist a quick call just to confirm. Simply ask them if you were supposed to have been given antibiotics or not. If they say no then you didn’t any. That’s great news because your stomach will thank you for it since they tend to cause GI issues.

Although we suppose there are times where the office was supposed to send you a prescription and your name got lost in the pile. That could’ve happened!

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