A survey of antibiotic prescribing by maxillofacial consultants for dental extractions following radiotherapy to the oral cavity

Kanatas, A.N.; Rogers, S.N.; Martin, M.V.
February 2002
British Dental Journal;2/9/2002, Vol. 192 Issue 3, p157
Academic Journal
journal article
Objectives: To analyse the antibiotic prescribing trends for exodontia and minor oral surgery in patients with a history of radiotherapy. Also, to evaluate the use of hyperbaric oxygen as a separate modality in the prevention of osteoradionecrosis. Design: A survey of antibiotic prescribing involving the analysis of a questionnaire which included the management of three patients with a history of head and neck malignancy. Method: The heads of the departments in each unit in the UK were sent a closed-response questionnaire. Antibiotic prescribing was assessed in three case scenarios. Case one referred to a patient that had surgery alone as part of the management of head and neck cancer, who needed the surgical removal of second molar roots. Case two referred to a patient that had surgery and adjuvant radiotherapy as part of the management of head and neck cancer, and needed the same procedure as in case one. Case three included a patient with a history of surgery and adjuvant radiotherapy, who required the extraction of three mobile and periodontally-involved lower incisors. Consultants were also asked about the use of hyperbaric oxygen in the patients who had radiotherapy as part of their treatment strategy. Results: A total of 109 questionnaires were sent to all the Maxillofacial Units in the UK. The response rate was 73%. In patients with a history of radical surgery alone for the management of head and neck cancer, 20% of the surgeons advocated pre-operative antibiotics for the surgical removal of lower posterior teeth. In contrast, in the patient with a history of adjuvant radiotherapy 86% supported pre-operative antimicrobial use for the surgical removal of the same teeth. In the extraction of mobile and periodontally involved lower incisors in the previously irradiated patient, 63% of the clinicians supported pre-extraction antibiotics. Postoperative antibiotics were advocated in 52% in the first case, 89% in the second case and 71% in the third case. 34% of the clinicians advocated hyperbaric oxygen for surgical removal of posterior teeth and 15% for the extraction of mobile anterior teeth. Conclusions: The use of peri-extraction antibiotics was favoured among oral and maxillofacial surgeons. There was little enthusiasm towards the use of hyperbaric oxygen as a prophylactic measure, alone or in conjunction with an antimicrobial regime. Control randomised trials that will measure the effectiveness of hyperbaric oxygen and the appropriate use of antibiotics for prophylaxis in pre- and post-operative regimes are necessary to evaluate the use of these modalities.


Related Articles

  • Oral and Dental Care for Cancer Patients Receiving Radiation and Chemotherapy. Carl, William // Quintessence International;Aug1982, Vol. 13 Issue 8, p845 

    The article presents the author's views on dental care for cancer patients, in response to some questions raised by dentist Donald George. According to the author, many teeth can be extracted without complications in cancer patients after they have received radiation and chemotherapy. The author...

  • Dental education: What are we going to do about it? Nelson, M. V. B. // British Dental Journal;11/27/2015, Vol. 219 Issue 10, p470 

    A letter to the editor is presented in response to the article "Oral surgery and the extraction crisis: What are we going to do about it?" by Megan Atkinson in the October 2015 issue.

  • Antibiotic use and abuse by dentists - Part 1. Amerena, Vincent C. // Australasian Dental Practice;Mar/Apr2012, Vol. 23 Issue 2, p108 

    The article discusses benefits and limitations of antibiotics. The study gives the prescribing pattern of antibiotics by general dental practitioners of North Carolina and paediatric dentists in treating dental infections. A recent report states that many US dentists over prescribe antibiotics...

  • Procedures adopted by orthodontists for space closure and anchorage control. da Costa Monini, André; Gandini Júnior, Luiz Gonzaga; dos Santos-Pinto, Ary; Martins Maia, Luiz Guilherme; Caetano Rodrigues, Willian // Dental Press Journal of Orthodontics;Nov/Dec2013, Vol. 18 Issue 6, p86 

    Objective: The aim of this study was to identify the procedures adopted by Brazilian orthodontists in the following situations: extraction space closure, anchorage control in case of necessary anchorage for group A and frequency of skeletal anchorage use, especially in the upper jaw. Method: A...

  • Displacement pattern of the anterior segment using antero-posterior lingual retractor combined with a palatal plate. Kyung-Won Seo; Soon-Yong Kwon; Kim, Kyung A.; Ki-Ho Park; Seong-Hun Kim; Hyo-Won Ahn; Nelson, Gerald // Korean Journal of Orthodontics;Nov2015, Vol. 45 Issue 6, p289 

    Objective: To evaluate and compare the effects of two appliances on the en masse retraction of the anterior teeth anchored by temporary skeletal anchorage devices (TSADs). Methods: The sample comprised 46 nongrowing hyper-divergent adult patients who planned to undergo upper first premolar...

  • Editorial. Doherty, Tom; Couturier, Francois; Donnelly, Jill; Lavy, Chris // Tropical Doctor;Oct2010, Vol. 40 Issue 4, p193 

    An introduction to the journal is presented in which the guest editors discuss issue about antibiotic prescription at a university hospital in Denmark.

  • Residency and antibiotics: Discovering the dogma of prescription. Fine, Bryan R. // Contemporary Pediatrics;Oct2001, Vol. 18 Issue 10, p70 

    Presents an article about the antibiotic prescribing practices of a pediatric resident.

  • Quality of prescribing of intravenous antibiotics in a district general hospital. Denton, Miles; Morgan, Marina S.; White, Ruth R. // BMJ: British Medical Journal (International Edition);2/9/91, Vol. 302 Issue 6772, p327 

    Focuses on the quality survey of prescribing of intravenous antibiotics in a district general hospital. Increase in the use of intravenous cannulas; Responsibility of the nursing staff for giving intravenous antibiotics at night; Difficulty for junior medical staff to give antibiotics at the...

  • New guideline on antibiotic prescribing aims to eliminate unnecessary use.  // Reactions Weekly;1/26/2013, Issue 1436, p3 

    The article reports on the launch by the Danish Health and Medicines Authority of a new guideline on the prescription of antibiotics.

  • Medicines management. Griffith, Matt // Nursing Standard;10/22/2008, Vol. 23 Issue 7, p28 

    The article presents question and answer about the benefits of delayed prescription for antibiotics.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics