Is antibiotic prophylaxis necessary for dental procedures?

A study published in the International Journal of Oral & Maxillofacial Surgerysuggests that, at least for third molar ('wisdom tooth') surgery, taking antibiotics preventively for certain dental procedtures may not be necessary. The authors set out to subject the use of antibiotics to prevent postoperative complications in third molar surgery to scientific scrutiny with a prospective, randomized, double blind, placebo-controlled clinical trial:

"100 patients were randomly assigned to two groups. Each patient acted as their own control using the split-mouth technique. Two unilateral impacted third molars were removed under antibiotic cover and the other two were removed without antibiotic cover. The first group received antibiotics on the first surgical visit. On the second surgical visit (after 3 weeks), placebo capsules were given or vice versa. The second group received antibiotics with continued therapy for 2 days on the first surgical visit and on the second surgical visit (after 3 weeks) placebo capsules were given or vice versa."

On days 3, 7 and 14 after the surgery patients were evaluated for infection, pain, swelling, temperature and trismus (tonic muscle spasm). What did the data show?

"Of 380 impactions, 6 sockets (2%) became infected. There was no statistically significant difference in the infection rate, pain, swelling, and trismus, and temperature between the two groups."

These findings may well shift the perspective on antibiotic prophylaxis for other dental procedures besides wisdom tooth extraction. The authors conclude:

"Results of the study showed that prophylactic antibiotics did not have a statistically significant effect on postoperative infections in third molar surgery and should not be routinely administered when third molars are removed in non-immunocompromised patients."