ADA Calls Antibiotics Unnecessary for Most Toothaches

Dentistry Today


The ADA does not recommend antibiotics for toothaches in most cases, according to a new guideline drafted to align with the organization’s antibiotic stewardship efforts and its pledged commitment to the United States government’s Antimicrobial Resistance Challenge.

Physicians and dentists often prescribe antibiotics to patients who have toothaches to help relieve their symptoms and prevent progression to a more serious condition, the ADA says. But the new guideline and accompanying systematic review find that healthy adults experiencing a toothache are best served not by antibiotics but by dental treatment and, if needed, over the counter pain relievers such as acetaminophen and ibuprofen. 

“Antibiotics are, of course, tremendously important medications,” said Peter Lockhart, DDS, chair of the ADA expert panel that developed the guideline and research professor at Carolinas Medical Center-Atrium Health. “However, it’s vital that we use them wisely so that they continue to be effective when absolutely needed.”

The ADA says that studies have shown that antibiotics, which are designed to stop or slow the growth of bacterial infections, don’t necessarily help people experiencing a toothache. Also, antibiotics can cause serious side effects, and overuse has resulted in bacterial strains that are resistant to antibiotics. The guideline offers example scenarios when antibiotics may be prescribed for a toothache.

“When dental treatment is not immediately available and the patient has signs and symptoms such as fever, swollen lymph nodes, or extreme tiredness, antibiotics may need to be prescribed,” said Lockhart. “But in most cases when adults have a toothache and access to dental treatment, antibiotics may actually do more harm than good.”

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