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August 9, 2004

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Question from Wisconsin, USA:

Our eight year old son will have eight teeth extracted for orthodontic reasons. The advise on whether or not he should take prophylactic antibiotics seems varied, according to what I read. The medical offices are unsure. I read a article by Dr. Victoria M.L. Brown at Dental Care - Tooth or Dare in which she says "Some patients may be prescribed antibiotics." (When discussing the diabetic having teeth extractions or gum surgery). What is the standard protocol for antibiotics before tooth extractions for diabetics? How do they choose who takes antibiotics before oral surgery or tooth extractions?

Answer:

Currently, there is no “standard” protocol for antibiotic prophylaxis for multiple extractions. I base the need on the glycosylated hemoglobin levels and history of the child’s vulnerability to wound infections. I would recommend a simple low level dosing of a basic antibiotic one hour prior to the extractions.

I also have a concern as to what may be a delayed eruption of the permanent teeth. If the eruption pattern seems out of step, evaluation of growth patterns may be warranted. If, after removal of the teeth and continued delay of new teeth continues, then definitely bone age and thyroid assessment should be done.

FV