Antibiotics for All Will Help Some After Wisdom Tooth Surgery
Noveber 28, 2012

By Nancy Volkers
InteliHealth News Service

INTELIHEALTH - Antibiotics can lower the risk of infection after wisdom teeth are removed. But they may not be useful in every case, says a review of published studies.

The review included 18 studies with a total of 2,456 people. All of the studies focused on people who were getting their wisdom teeth removed. In some people, the wisdom teeth were impacted, or stuck in the jaw bone.

Some people were randomly assigned to get antibiotics. Others took placebo pills. These looked like antibiotic pills but did not contain any medicine.

Researchers from the Cochrane Collaboration combined data from all of the studies. They said that antibiotics probably reduce the risk of infection by about 70%. According to the researchers, this means that 12 people need to take antibiotics in order to prevent 1 infection.

The data also showed that antibiotics reduced the risk of dry socket by about 38%. Dry socket happens when the blood clot falls out after a tooth is removed. This can expose the bone and nerve, causing pain and sometimes infection. The researchers calculated that 38 people have to take antibiotics to prevent 1 case of dry socket.

There was also some evidence that antibiotics can reduce pain during the week after the teeth are removed. This could be due to the lower risk of infection, said the researchers.

They did not find that antibiotics reduced the risks of fever, swelling, or problems opening the mouth. The research did show that people taking antibiotics are about twice as likely to have mild, unwanted side effects. This means that for every 21 people taking antibiotics, one will have an unwanted side effect.

The researchers noted that their findings may not extend to people who have chronic illness or weakened immune systems. They also may not apply to people who get antibiotics when teeth are removed for other reasons, such as severe decay or periodontal disease.

Because antibiotic-resistant bacteria are becoming more common, the researchers note that dentists should think carefully about which patients need antibiotics for wisdom-tooth removal and which do not.

The researchers said that 13 of the 18 studies were at high risk of bias. This could make their conclusions less reliable. Some of the reasons for possible bias included the following:

• Not all studies explained how they randomly assigned people to receive either antibiotics or placebo.
• Not all studies explained how the type of treatment (antibiotics or placebo) was kept secret from study members and from researchers.
• Some studies did not explain how people were chosen to participate.
• In some studies, quite a few people stopped participating during the study, so researchers could not collect information on them at the end of the study. This could have skewed the final results.

The study appears in the November 14 issue of the Cochrane Database of Systemic Reviews.