While antibiotics are appropriate in the management of certain dental infections, they are not indicated if the pain results from inflammatory (non-infective) or neuropathic mechanisms. The degree of pain is not a reliable indicator of acute infection.
There is evidence that Australian dentists and doctors are using antibiotics empirically for dental pain, rather than making careful diagnoses of the causes of the pain.1 Most dental emergency situations involve patients with acute inflammation of the dental pulp or the periapical tissues. Prescribing antibiotics for these conditions will not remove the cause of the problem nor destroy the bacteria within the tooth.
Antibiotics should be limited to patients with malaise, fever, lymph node involvement, a suppressed or compromised immune system, cellulitis or a spreading infection, or a rapid onset of severe infection.
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