Necessity of Antibiotic usage after Simple Tooth Extraction in Patient with Healthy Systemic Condition in Herat, Afghanistan

Over-intake of antibiotics like amoxicillin, penicillin, ceftriaxone, gentamycin, ampiclox, metronidazole and last but not least, tetracycline is a practical hazard in aid-supported settings such as Afghanistan where not only one can get access to them easily, but also they are generously being prescribed without consideration for necessity or side effects. Prescribing antibiotics after simple tooth extraction has remained a questionable topic in dental academia, especially in the third world countries. Among dental procedures, extraction is the most common procedure for the prescription of antibiotics. This study is aimed to determine the necessity of using antibiotics after simple tooth extraction in people with a normal systemic condition and establish its role in reducing pain and discomfort, swelling, and dry socket.

This double-blinded RCT study was performed in two dental surgeries; Erfan Specialized Dental Clinic and Mena Oral and Dental Care Centre. In all 237 patients, selected systematically, randomized, tooth extraction was performed following the same protocols and materials before and after tooth extraction. Two types of prescriptions (one with antibiotics and one without antibiotics) were prepared in a box. After tooth extraction participants were asked to pick one prescription by chance. All data were collected and analyzed with the SPSS-25 program.

Among all participants 76.37% were female and 23.63% were male. Regarding reasons that led to tooth extraction, 43.04% of teeth were extracted due to profound caries, making it the most common reason followed by periodontitis 14.77% and root remnants 10.55%. Pain and discomfort peaked in the first 10 hours after extraction and gradually decreased up to 48 hours after extraction.

Swelling was observed 2.53% more in antibiotic users than 0.42% in those that didn’t take them and the p-value was significant <0.05. There is no obvious difference between antibiotic usage and dry socket formation, and the p-value was not significant (>0.05).

Antibiotics are not necessary after simple tooth extractions in patients with a normal systemic condition, even in countries like Afghanistan where patients overuse antibiotics, nor do they have any role in reducing pain, swelling, and dry socket after simple extractions.