Use of antibiotics in children with dental decay
For decades, antibiotics have greatly benefited the medical community’s efforts to fight bacterial infections. However, we now face a new challenge with bacteria becoming resistant to this treatment modality as a consequence of widespread (and often unnecessary) use. Providers are now learning to be more prudent in appropriate prescription of these drugs. Here’s some things to know about current recommendations and guidelines:
1- In an otherwise healthy child, abscess from dental decay localized to the tooth or surrounding tissues is not an indication for use of antibiotics. The tooth however, needs to be treated as soon as possible.
2- When an acute infection that originated from tooth decay becomes systemic (ie. facial swelling, fever), oral and or intravenous antibiotics may be indicated.
3- Oral wounds at times require antibiotics. The provider needs to consider, amongst other things, the extent of damage as well as nature of contamination of wound.
4- When impact to the face has occurred, certain types of dental trauma may benefit from localized or systemic use of antibiotics to improve healing and long term prognosis of involved teeth.
5- Some gum diseases may require localized or systemic use of antibiotics . These conditions occur very rarely in children and should involve careful evaluation and a multifaceted treatment plan.
Of note, tetracycline and similar antibiotics are known to internally discolor developing teeth. Ask your child’s provider for details and I hope this post inspires parents and providers to consider guidelines before throwing antibiotics at a child with a dental issue.
Dr J is a board certified pediatric dentist, serving his hometown in San Diego at one the most respected specialty practices, Scripps Pediatric Dentistry. He is an honors graduate of UC Berkeley, and UCLA School of Dentistry. His specialty training was completed as Chief Resident at UNC, one of only 2 three year pediatric programs in the US. He is an associate professor at UCLA in pediatric dentistry and on staff at Rady Children’s Hospital. He is also a proud father to two girls.