Are Antibiotics Necessary for Oral Surgery?

In the Literature

Blazevich M, Miles C. The presence of bacteremia in 13 dogs undergoing oral surgery without the use of antibiotic therapy. J Vet Dent. 2023:8987564231207208. doi:10.1177/08987564231207208

The Research …

Periodontal disease is diagnosed in ≈85% of dogs >2 years of age.¹ Bacteremia is a recognized sequela of dental scaling and oral surgery in patients with severe periodontal disease.^2-4

The aim of this study^a was to assess whether transient bacteremia developed after dental scaling, root planing, and dental extractions, as well as whether the amount of bacteremia warranted antibiotics. Client-owned healthy dogs (n = 13) with mild to severe periodontal disease received a complete dental cleaning with root planing and extractions as needed. Blood culture samples were collected at the time of IV catheter placement, 5 minutes after initiation of the procedure, 5 minutes after the first extraction, at the end of the procedure, and 1 hour after the procedure.

Bacterial growth was noted in 38.5% of blood samples across all cases at any given collection time. No bacteremia was present in samples collected before dental cleaning or one hour after the procedure, indicating bacteremia detected during the procedure resolved within one hour in the absence of oral or IV antimicrobial administration. The authors concluded that these findings do not support the use of pre-, peri-, or postoperative antibiotics for dental procedures in otherwise healthy patients.

… The Takeaways

Key pearls to put into practice:

• Although bacteremia may occur as a result of dental procedures, bacteria were not identified pre- or postoperatively in this study, regardless of the degree of periodontal disease or extent of treatment/exodontia. Perioperative use of systemic antibiotics for dental procedures in healthy dogs may not be warranted.

• This study did not evaluate use of antibiotics in patients with conditions other than periodontal disease. Systemic bacteremia may not be the only criteria on which to base use of antibiotic therapy. Antibiotic therapy may be warranted in dental patients with certain conditions (eg, cardiac disease, immunocompromise, metabolic disorders [eg, diabetes mellitus]) based on clinical judgement.

• A limitation of this study was small sample size. A study with a larger number of patients that includes assessment of postoperative wound healing could help support the conclusions of this study.

^a This study was supported by Zoetis PetCare and IDEXX Laboratory.