Use of Antibiotics After Dental Implant

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. 

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.

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. 

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.

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!