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Daniel Sheibley, MD
Daniel Sheibley, MD, Doctor
Category: Medical
Satisfied Customers: 1834
Experience:  MD Grad Jefferson Medical College 2009. Internal Med intern 2010 & Radiology residency 2011. Husband & father of two.
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Hello. My husband had a tooth extracted this morning. He

Customer Question

Hello.
My husband had a tooth extracted this morning. He had lost part of the tooth, and then suffered from pain, especially on eating. It was a straightforward extraction, and he is showing no signs of a severe infection (e.g. swelling). We were surprised that the dentist prescribed him a significant amount of antibiotics: 400mg amoxycillin and 500mg metronidazole, each 3 times a day for 5 days. These both seem like heavy doses; is it normal to do that? Would it be sensible to wait and give the body's immune system a chance to look after itself? My husband is otherwise completely healthy.
Submitted: 2 years ago.
Category: Medical
Expert:  Daniel Sheibley, MD replied 2 years ago.
Daniel Sheibley, MD :

Hello

Daniel Sheibley, MD :

These are perfectly normal dosages.

Daniel Sheibley, MD :

It is routine to give antibiotics for any tooth extraction because despite his overall health, if he were to get an infection it could be very dangerous.

Daniel Sheibley, MD :

Dental infections can easily spread into the skull base and into the brain

Daniel Sheibley, MD :

so there should be no messing around with waiting to see how things go.

Customer:

OK, that's scaring me now.

Daniel Sheibley, MD :

Haha, well he is on antibiotics so he should be fine

Daniel Sheibley, MD :

Exactly, that is why they give antibiotics

Daniel Sheibley, MD :

it is easier to give them and people not have needed them than to deal with some pretty hard consequences

Daniel Sheibley, MD :

If he got an infection it would spread along the bone right away and bone-associated infections are very hard to eradicate

Customer:

I found several websites saying that one _doesn't_ routinely offer antibiotics after a dental extraction. A few years ago, I had a tooth extracted, with a chronic abscess, and I wasn't prescribed anything. I'm surprised how strong your reaction is.

Daniel Sheibley, MD :

Here in the us it is common to have antibiotics.

Daniel Sheibley, MD :

We don't give them as prophylaxis to people having dental work done if they have heart problems (we used to do that)

Daniel Sheibley, MD :

but after a surgical procedure of extraction you do not want an infection.

Daniel Sheibley, MD :

If a dentist didn't give me antibiotics I'd wonder why the heck they didn't.

Daniel Sheibley, MD :

you do have varying reports online about it, and even some papers debating it

Daniel Sheibley, MD :

whether it is needed or not

Customer:

Is it worry about the original infection spreading, or a new infection arising from the procedure?

Daniel Sheibley, MD :

Both

Daniel Sheibley, MD :

if he had fractured the tooth and it got infected or happening after the procedure

Customer:

OK, thanks. Your position on this debate seems clear-cut. I guess taking antibiotics is in his best interests now, and the argument against is more to do with the long-term?

Daniel Sheibley, MD :

I'd prescribe atibiotics for certain

Daniel Sheibley, MD :

yes. there would be short term antibiotics only

Daniel Sheibley, MD :

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Expert:  Daniel Sheibley, MD replied 2 years ago.
Yes. I'd say 50:50 people would or wouldn't but i'm very strong against having to deal with a very complicated infection of the facial bones.

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