Avoiding Amoxicillin During Wisdom Teeth: What are the Possible Problems

An interesting article titled “Dental Care Professionals Should Avoid the Administration of Amoxicillin in Healthy Patients During Third Molar Surgery: Is Antibiotic Resistence the Only Problem?” appears in the 2016 Journal of Oral and Maxilofacial Surgery written by Othoniel H. Aragon-Martinez and et al. (vol. 74, pp. 1512-1513). The authors attempt to explain why amoxicillin should not be used during wisdom teeth surgery.

Amoxicillin is commonly used to prevent infections. Information from high quality clinical trials has shown that amoxicillin is not effective to reduce the risk of wound infections when it is received both preoperatively and postoperatively.  Recent evidence has shown that the administration of 250 mg of amoxicillin in healthy volunteers every 8 hours for 7 days produces  antibiotic resistance.

The authors also discuss the topic of dysbiosis. Dysbiosis is a detrimental modification in the composition of the microbiome alongside altered microflora functions, which can be produced by antibiotic exposure, type of diet, lifestyle habits, and other factors. Amoxicillin causes marked alterations in fecal microbiota during the treatment course. Dysbiosis in can produce harmful changes in health, including the accumulation of antimicrobial resistances, increased susceptibility to infectious diseases, altered immune homeostasis, and deregulated metabolism. This could contribute to a delayed onset of local infection of wisdom tooth extraction.

The author states

“The present information suggests that intestinal and oral microbiota changes under the amoxicillin exposure, returning to the original species profile within 2 months; however, these microflora modifications may continue for a prolonged period in some patients, increasing the risk of the establishment of dysbiosis related diseases.”

The authors bring up some interesting points about why to avoid using amoxicillin when having wisdom teeth surgery performed which I have not seen talked about widely in other places. They believe amoxicillin has no scientific evidence to support its use in wisdom teeth removal for healthy patients.

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