This question is posed in an article in JOMS August 2019. (J Oral Maxillofac Surg 77:1557-1565, 2019) As long as patients understand the concerns and risks associated with treatment with or without antibiotic coverage I am happy to provide care either way. We have a great deal of experience in providing care under both scenarios. My experience is that the risk of not using prophylactic antibiotics far outweighs the risks of taking the drugs or the concerns associated with the cost of taking the drugs. There are certainly exceptions and of course every case has its own set of variables that may affect the decision and these should be evaluated and discussed with your surgeon. In our practice we do this. I am aware of the many opinions put out on the internet, especially the warnings against the overuse of antibiotics.

As a routine I would recommend prophylactic antibiotic coverage after oral surgery procedures. There has also been quite a bit of study about taking a premed antibiotic before oral surgery procedures and this has been shown to be helpful in reducing infection risks. The oral environment naturally harbors many microorganisms and viruses. Surgical procedures, however sterile, still trap these organisms in surgical sites and introduce them into deeper tissue layers.

If you are an otherwise healthy patient the likelihood that you will tolerate the drugs well is good. For my family, I would recommend taking the antibiotics. If you are immune compromised or are at greater risk because of age or medical conditions – for my family I would recommend taking the antibiotics and even a premedication. For those who have problems or sensitivities with antibiotics, it is reasonable to avoid them as is possible. Certainly there are specific circumstances that might skew the decision one way or the other and we should discuss these.