Treatment of acute dental infections

The Nordic guidelines highlight that antibiotics should be prescribed only with strict indications and the use of broad-spectrum antibiotics should be avoided.

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Antimicrobial resistance is globally a growing public health threat. Constrained and appropriately targeted use of antibiotics in health care could slow down the development of antibiotic resistance. Dentists are responsible for a substantial proportion of all antibiotic prescriptions, thus it is important that dentists know optimal principles and practices of using antibiotics. In Nordic countries, national guidelines have an important role as a source of up to date knowledge and expert opinion on treatment of dental infections including the use of antibiotics. The Nordic guidelines highlight that antibiotics should be prescribed only with strict indications and the use of broad-spectrum antibiotics should be avoided. At the same time, it should be kept in mind that common, localised dental infections may occasionally develop into severe life-threatening infections. Whenever antibiotic treatment is considered in addition to surgical drainage it should be started an hour before the procedure to avoid spread of the infection when manipulating infected tissues. It is essential that dentists can identify the patients with systemic infection or increased infection risk. Antibiotics are needed in severe infections and for patients with increased risk of infection complications, but primarily, acute dental infections are always treated by efficient drainage and elimination of the infection focus.

Klinisk relevans:

Localised dental infections are primarily treated by drainage and elimination of the infection focus. In addition, antibiotics are needed in systemic or spreading infections. Because dental infections may occasionally develop into systemic, life-threatening infections, it is important that dentists can identify patients that need antibiotics and/ or referral to hospital. Knowledge on good practices in the use of antibiotics is important as increasing antibiotic drug resistance is a global health threat. It is important that dentists follow the general principles in antibiotic use in medicine and take part in the fight against antibiotic resistance in their community.

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Nr. 5 | 2019

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Nr. 5 | 2019

forfattere

Mataleena Parikka

docent, ph.d., dentist, Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland and Oral and Maxillofacial Unit, Tampere University Hospital, Tampere, Finland

Anna Norppa

dentist, ph.d., Oral and Maxillofacial Unit, Tampere University Hospital, Tampere, Finland

Hannamari Välimaa

postdoctoral fellow, consultant in clinical microbiology, ph.d., specialist in clinical microbiology, Haartman Institute, Department of Virology, University of Helsinki, Department of Oral and Maxillofacial Surgery and Helsinki University Hospital Laboratory, Helsinki University Hospital, Finland

Reetta Huttumen

docent, deputy chief phycician, ph.d., Tampere University Hospital, Department of Internal Medicine and Infectious Diseases, Tampere, Finland

Asko Järvinen

head of Department, adjunct Professor, MD, PhD, specialist in internal medicine, infectious diseases and clinical pharmacology, Department of medicine, Clinic of Infectious Diseases, Helsinki University Hospital, Aurora Hospital, Helsinki, Finland

Riina Richardson

lecturer in oral medicine and Senior Clinical Research Fellow and Honorary Consultant in Infectious Diseases, Adjunct Professor, DDS, PhD, FRCPath, Institute of Dentistry, University of Helsinki, Finland, Department of Oral and Maxillofacial Diseases, Helsinki University Hospital, Finland, and Manchester Academic Health Science Centre, School of Translational Medicine, University of Manchester and University Hospital of South Manchester, United Kingdom