According to a new study in Australia, prophylactic antibiotics for dental implant surgery are no longer necessary and may contribute to antibiotic resistance.
Dental implants are an increasingly popular dental treatment because of their high success rate and durability. Many patients also choose dental implants because they function and are cared for just like regular teeth. Over 3 million people in the United States have dental implants, according to the American Academy of Implant Dentistry, and this number grows by half a million implants each year.
Many of these implant patients are given antibiotics as part of their procedure to prevent infection. The goal is to prevent bacteria in the mouth from growing and entering the bloodstream.
The study, published in the Australian Dental Journal, found that dental patients in good health do not need antibiotics as a preventative measure during surgery to place a dental implant. The study’s authors make the claim that antibiotics have been prescribed overzealously, and that 70 percent of dentists around the globe prescribe antibiotics as part of implant prosthodontic treatment.
Antibiotics are a type of drug used to kill bacteria. Since the discovery of penicillin in 1928, doctors have used them to treat patients to kill or limit the growth of bacterial infections and diseases.
The Biology of Antibiotic Resistance
Over time, some of the bacteria these drugs were designed to treat became resistant to medication and continued to multiply even though the patient was taking appropriate levels of the prescribed drug.
Antibiotic resistance develops naturally. When a patient is prescribed an antibiotic, the medicine kills off the weaker bacteria, leaving behind the strongest bacteria. To survive, bacteria adapt to resist antibiotics by genetically mutating themselves to fight against medicine or by adopting another bacteria’s bacterial resistance.
Bacteria can also create their own antibiotics to kill off other bacteria so that they ensure their own survival.
Antibiotic overuse is the largest contributor to antibiotic resistance. In the United States, antibiotics are prescribed at a high rate, but in other countries the medicine can be purchased over the counter without a prescription. A growing concern is the availability of antibiotics on the black market.
Antibiotic misuse also contributes to antibiotic resistance, including when patients take antibiotics to treat viruses like colds or the flu.
Why is Antibiotic Resistance Dangerous?
Antibiotic bacterial resistance is dangerous, because some bacteria can cause serious illness or even death. According to the Centers for Disease Control and Prevention, over 20,000 people in the United States die because of antibacterial resistance. This includes individuals dying from superbugs – bacteria that have developed resistance to every one of the 26 antibiotics available in the United States.
“Bacterial resistance is a growing concern, so it is important that prescriptions are written judiciously and patients take antibiotics directly as prescribed,” said Dr. Stefania Caracioni, D.D.S., L.V.I.F..
Caracioni is a Topeka, Kansas, dentist who performs dental implant restorations.
In many cases, patients are given an antibiotic regimen and do not finish their whole prescription, only taking them until they feel better or taking them inconsistently.
Assessing the Health of Dental Implant Patients
In order to minimize infection risk, Caracioni evaluates implant patients prior to surgery to look for signs of infection already present.
“One of the telltale signs of infection is if a patient has periodontal disease,” Caracioni said.
Periodontal disease is a painful and serious gum infection that can lead to loss of teeth and gum tissue. It can also cause more serious health complications like endocarditis, an infection of the lining of the heart muscle that can be fatal.
Caracioni also takes in the health history of the patient, looking for conditions that may put them at risk of infection complications. These conditions are both medical, like diseases or illness, and behavioral, like smoking or using other tobacco products.
Once assessed, Caracioni determines if the patient is ready for the implant or if they need treatment for periodontal disease or any other health condition before proceeding.
“Minimizing the risks before surgery minimizes complications after surgery,” Caracioni said.
Dentistry Today. “Antibiotics Unnecessary for Healthy Dental Implant Patients.” Dentistry Today. 7 June 2017.