Just Ask the Expert: Tooth extractions and antibiotics

Dr. Carmichael welcomes dental questions from veterinarians and technicians.

To ask your question, e-mail: vm@advanstar.com

With the subject line: Dental Questions

Q: When a dog requires multiple extractions, how long after the dental should it receive antibiotics?

A: Considering the emergence of antibiotic-resistant strains of bacteria, it is clearly in our best interest to use antibiotics judiciously. However, antibiotics can be used before oral surgical procedures, such as multiple extractions, to improve tissue health and reduce bacterial aerosolization. Healthy oral tissue is easier to suture. Antibiotics are also used prophylactically when procedure-related bacteremia is a concern. In animals that are healthy, this bacteremia is handled by the immune system, and antibiotics are not necessary. Sick animals, animals with organ system failure, and animals with compromised immune systems are candidates for systemic antibiotic prophylaxis.

If it has been determined that antibiotic therapy will be appropriate in a given case, the ideal time to start would be four to five days before the dental treatment, and continue antibiotic administration for five to seven days after the treatment. Choose an antibiotic that is effective against gram-negative, anaerobic bacteria. Bacterial cultures of the oral cavity are worthless. Clindamycin (10 to 22 mg/kg orally every 24 hours or divided) is a good choice for treatment of oral infections, especially when bone involvement is suspected. Amoxicillin-clavulanate (12.5 to 22 mg/kg orally every 12 hours) is another good choice, especially when a broad spectrum of protection is desired.