Antibiotics And Root Canals: What You Need To Know

If you're scheduled to have a root canal done, you've no doubt seen instructions regarding taking antibiotics as part of the recovery because of an infection in the tooth. However, this is a bit controversial. While root canals are usually done because the pulp of the tooth has become infected, antibiotics might not always be necessary just because you're having a root canal done. Antibiotic resistance has become an issue in medicine, including endodontic procedures, and you must be sure the antibiotics are warranted.

Antibiotic Resistance

What happens in antibiotic resistance is that an antibiotic will initially knock out the majority of the bacteria causing a problem, making the patient feel a lot better. But some bacteria is usually still alive at this point -- it's just not enough to make the patient feel bad. If you stop taking the antibiotic at this point, you're giving the bacteria a chance to recover and develop defenses to that antibiotic. And thus antibiotic resistance increases. To combat that, you have to take the full course of antibiotics that you've been prescribed, even if you feel fine after a day or two.

Reasons to Take

Do understand that if you are undergoing a root canal because of an obvious infection that is beginning to spread or that has spread outside the tooth pulp, you really do need the antibiotics. If your dentist says he or she wants you to take the antibiotics because you have signs of an infection that is affecting your body, that's spreading, or that is basically doing anything, chances are you need to take the antibiotics.

Not Always Clearly Beneficial

However, if the infection is confined to the tooth pulp, then the use of antibiotics becomes less clear. The National Health Service in the United Kingdom notes that if the infection is confined to the tooth pulp and is thus inaccessible through your bloodstream, then antibiotics might not be effective because they can't reach the infection. Tufts University notes that the improvement often attributed to antibiotic use may in fact be something the patient would experience anyway without antibiotics.

Even the American Association of Endodontists notes that sometimes antibiotics just aren't called for, though the association is much more cautious about avoiding antibiotics. (Warning: medically graphic images.) The association says signs of infection should be treated with antibiotics, but if there are no signs of infection, and any swelling is localized and small, then antibiotics really aren't required.

Being Informed Is Best

If your dentist wants you to take antibiotics and you're truly concerned because you've had previously bad experiences with that type of medicine, do the following:

  1. Talk to the dentist first if possible. If the root canal is an emergency procedure and you don't have time to think about it, you might not have a chance to talk; do what the dentist says. Just be sure the antibiotic he or she gives you is one you haven't had an issue with. Notify your regular doctor if you need to take other precautions due to previous problems with things like yeast infections, which can get worse when you're on antibiotics.
  2. Find out why dentist wants you on antibiotics. Not all dentists will prescribe them, but if yours says you must take them, find out exactly what symptoms of infection the dentist is seeing. If the dentist is prescribing them "just in case," get a second opinion. Overprescription of antibiotics is another contributor to antibiotic resistance.
  3. If you're prescribed antibiotics because the dentist is seeing signs of infection, take the medicine as directed for the whole course even if you feel better before all the pills are taken.