They are usually caused by a mix of aerobic and anaerobic bacteria, predominantly Streptococcus species and anaerobic Gram-negative rods.
Selecting the right antibiotic is critical to controlling infection and preventing complications.
First-Line Choice: Amoxicillin
Amoxicillin remains the antibiotic of choice for most dental infections due to its:
★ Excellent oral absorption.
★ Wide tissue distribution.
★ Broad activity against common oral pathogens.
★ Favorable safety profile.
Recommended dosage (adults): 500 mg every 8 hours for 5–7 days.
In severe infections, Amoxicillin-Clavulanic acid is preferred to extend coverage against beta-lactamase–producing bacteria.
For Penicillin-Allergic Patients
When penicillin allergy is present, Clindamycin is the most recommended alternative, offering strong activity against anaerobic organisms and good bone penetration.
► DENTAL BOOK: Mosby's Dental Drug Reference, 13th Edition – A Must-Have Guide for Every Dental Professional (2021)
Other Alternatives
★ Azithromycin: useful in patients intolerant to clindamycin, with once-daily dosing.
★ Metronidazole: often combined with Amoxicillin to strengthen anaerobic coverage.
Important Clinical Note
Antibiotics alone cannot resolve a dental infection. Definitive dental treatment—such as drainage, root canal therapy, or tooth extraction—remains essential.
Antibiotics serve as an adjunct to control the spread of infection and systemic involvement.
Key Takeaways
★ Amoxicillin is first-line for most dental infections.
★ Amoxicillin-Clavulanic acid is indicated in more severe cases.
★ Clindamycin is the best choice in penicillin-allergic patients.
★ Antibiotics must always be combined with definitive dental treatment.
