Use of Antibiotics After Dental Implant

I had an implant placed 2 days ago and been taking erythromicin for 3 days(1 day pre oper. and 2 after), but I had to stop because of severe side effects. I am alergic to penicilin, thus limited on choice. Is it too risky if I dont take them at all? The implant site seems fine, swollen but with no pain, even though i had some bone augmentation done (artificial) and membrane placed. My Dr says the protocol is 7 days of antibiotics.Also, if i re-start taking them, how long should i continue for?

Doctor Answers 7

Antibiotics after dental implants

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Although no strict protocol for antibiotic use has been established within the field of implant dentistry, one must understand that placement of a dental implant involves instituting a foreign body within the human body.  Titanium metal (which dental implants are made of) is biologically inert and will not be rejected by the human body.  However, bacteria that may be on the implant surface prior to placement in your mouth can elicit a foreign body response, leading to inflammation, encapsulation with scar tissue and ultimately, failure. 

How can bacteria get on a dental implant before being placed, you may ask?  During implantation, the dental implant fixture (which is sterile) comes into contact with fluids within the oral cavity (which are not sterile); bacteria in the mouth latch onto the implant surface and are then transferred into the implant site.  Usually, the body can take care of a few microbes without antibiotics, but if left to propagate, the bacteria will colonize the implant surface and prevent a normal healing response which will ultimately allow bone to grow onto your dental implant. 

For my own patients, I recommend antibiotics before and immediately after implant placement.  I am even more emphatic about this if a bone graft with membrane was completed, since membranes can harbor a significant amount of bacteria during the first few hours/days following implant placement. 

Follow your doctor's advice and consult with him/her regarding the use of an antibiotic.  There are alternatives out there if you have an allergy or if you cannot tolerate a specific type of antibiotic.  Good luck!

Manhattan Dentist

Antibiotics after dental implant surgery

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If you are having side effects with the E-mycin, you can switch to another medication or simply rinse with an antimicrobial mouth rinse like Peridex. Risk of post-op infection is under 1% so no worries. Just keep the area clean and favour the site by not biting or chewing on it. 

Herbert Veisman, DDS
Toronto Periodontist

Antibiotic After Dental Implants

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There has been numerous research papers written on this topic with no strict answer.  Most surgeons, including myself prescribe an antibiotic for a week after implant placement.  The theory is that the implant is a foreign body and is easily colonated by oral bacteria. This can lead to implant failure or infection of the implanted device.  Since research has not provred this to a certainty, some surgeons choose not to place patients on antibiotics.  An antibiotic mouthwash is also often employed. I use both in my practice.

Brian Dorfman, MD, DMD
Phoenix Oral & Maxillofacial Surgeon

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Antibiotics After Implant Placement

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If you had a considerable amount of bone grafting done with the placement of the implant it would certainly be a good idea to take a round of antibiotics.  That being said, you are not ensuring an infection  by any means ,if you choose not to take them.  To be safe your doctor could switch you do a different antibiotic that you may tolerate better.  If you are going to take them I would do a full seven day regimen.  Clindamycin would be a good choice, but contact your doctor immediately if you begin to experience an upset stomach or diarrhea. 

Antibiotics after implant placement

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The standard protocol in implant-related surgeries is based on the underlying research. Post- operative infection is one of the common factors of implant complications. Mouth cavity can never be a sterile environment no matter of what precautions be taken before the surgery and the degree of reinfecting the surgical site and the place where the implant is inserted is extremely high. This microflora can interfere with the process of post-surgical healing- implant osseointegration. So, the standard recommendations of International Team for Implantology, American Academy of Periodontics include the 7-day antibiotics protocol without any exceptions. In the situation of penicillin allergy clindamycin/cleocin is prescribed to the patient for 7 days. If you have stopped and restart taking them - consider it to be a new course, which will be 7 days as well.

Antibiotics after implant surgery

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I also recommend antibiotics to my patients, usually for 7 days to help prevent infection, specially if it is a more complex treatment requiring grafting. However, this does not mean that one will have infection if they don't take antibiotics. It is just a preventive measure. If you are sensitive to Erythromycin, the Clindamycin is a good alternative.

H. Ryan Kazemi, DMD
Bethesda Oral & Maxillofacial Surgeon
5.0 out of 5 stars 7 reviews

Antibiotics after dental implant is a good idea, but may be fine without

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Success with dental implants is a factor of probabilities.  The odds for success increase with more precautions, pre-surgical planning and post-operative care.  Implant success rates are very high, usually quoted in the 98% success range.  Success goes down if the patient does not care for the site after the surgery, it goes down if there is presence of infection or poor bone quality and goes down if the design of the implant is not correct for the situation (among many other variables).  The rate goes DOWN, but not to ZERO.  Some cases work despite doing nearly everything wrong...!

Some dentists do not routinely prescribe antibiotics and still have successful implant cases.  Their success rate may increase with using antibiotics, but may not (it is all a matter of odds).

You are likely fine, but may consider a different antibiotic with fewer side effects.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.