Antibiotics do not improve outcomes of dental implant surgery, a large Malmö University study shows. Conversely, overuse can promote antibiotic resistance.

Dental implant surgery carries a risk that the implant will not heal into the jawbone because of infection. However, the newly published study suggests antibiotics are not needed prior to the procedure.

Studies show that a single dose of antibiotics can cause antibiotic resistance in bacteria in the oral cavity. Antibiotics should, therefore, be avoided unless it is certain that the benefits outweigh the risks.

Palwasha Momand

The researchers investigated 474 patients who received either antibiotics or a placebo before their implant surgery. The aim was to see if more complications occurred in the placebo group.

“Our conclusion is that there was no difference between these groups, suggesting that healthy patients in uncomplicated implant operations do not need antibiotics,” says Palwasha Momand, the main author of the publication. “Overuse can lead to antibiotic resistance and is thus a threat to public health.”

The risk is well known, and healthcare providers are constantly seeking to reduce unnecessary use of antibiotics; yet there are no clear guidelines on antibiotic use in dental implant treatment. Preventive antibiotic treatment has been a standard practice for implant surgeries, even though its efficacy has not been proven.

“Antibiotics should not be given just for the sake of it. There must be a clear indication that they are needed,” says Bengt Götrick, associate professor and senior dental officer. He names two risk groups for which preventive use of antibiotics is clearly justifiable: patients with a severely weakened immune system and cancer patients who have received high-dose radiation to their jawbone.

Taking antibiotics is never risk-free, and determining who needs them is a balancing act.

“Studies show that a single dose of antibiotics can cause antibiotic resistance in bacteria in the oral cavity. Antibiotics should, therefore, be avoided unless it is certain that the benefits outweigh the risks,” Momand says.

Text: Magnus Jando & Anna Jaakonaho

More about the study on antibiotics in dental implant surgery

The study was conducted at seven different clinics in Sweden. The patients were randomly assigned to a group that received a placebo and a group that received two grams of antibiotic prophylaxis.

Read the whole study:

Effect of antibiotic prophylaxis in dental implant surgery

Palwasha Momand’s report on the study was awarded the prize of the best research report at the Annual Dental Congress and Swedental in October 2021.