My Dentist Didn't Give Me Antibiotics After a Tooth Extraction

You just had a tooth extracted but your dentist only gave you a prescription for pain medication and a bag of gauze. Why didn't your dentist give you any antibiotics? Is he not worried that you're going to end up with an infection since you have a gaping wound in your mouth?


This article will explain some of the possible reasons why you may not have received any antibiotics after having a tooth removed.



You didn't get any antibiotics because your face was not swollen

Antibiotics are typically prescribed after a tooth extraction IF there is a lot of swelling in the mouth or on the face. The swelling will most likely go away after the extraction but taking antibiotics will accelerate the healing, clear out the infection faster, and reduce the chances of it reoccurring.


severe facial swelling

The most important part of treating an infection is to get rid of the source. The source often stems from the tooth so removing the tooth will remove the source. Antibiotics don't actually treat the source of the infection but rather act as an adjunctive secondary therapy. This is why you can still be swollen if you only take antibiotics and not remove the source.


What the antibiotics do is speed up the healing by clearing out the infection faster. It does so by killing off any residual bacteria that may have been left behind after the tooth was removed. Although the body's natural immune system would've cleared out the remaining bacteria regardless. The medication just speeds up the process.


It is also not uncommon for infections to return even after the tooth is extracted. Sometimes the residual infection is still potent enough to overwhelm the immune system. By taking antibiotics you can reduce the possibility of that happening.


Therefore, if you weren't very swollen it simply means that the infection wasn't as severe. Your dentist probably thought that your natural immune system should be able to clear it out just fine all on its own.



A minor infection does not require antibiotics

Only severe infections require antibiotics while minor ones do not. The main reason is because the most important part of treating an infection is by removing the source of it. An extraction will definitely get rid of the source, which will halt the progression of the tooth infection.


As long as the source is gone, the rate of the infection should slow down significantly. This is usually sufficient for your body's immune system to clear it out naturally without the help of antibiotics.


However, very severe infections do require the use of antibiotics for multiple reasons:

  • Your dentist is unsure if he removed all of the infection. If during the extraction, if your dentist feels like he may not have been able to clean out the infection enough... he may prescribe you some antibiotics to cover his bases. Sometimes it may not be possible to locate and get rid of the entire tooth abscess.

  • Unsure about the exact source of the infection. There is the possibility that there could be multiple sources of infection. If your dentist thinks that removing the tooth may not have been the sole cause, you may need to take antibiotics to buy more time to clear out the infection. You should expect that an additional procedure may be required later if it turns out that there is an additional source of a dental abscess.



The standard of care after extracting a tooth

You may be surprised but the standard of care is to minimize the amount of antibiotic prescriptions after a tooth extraction. Studies have shown that there is no evidence in taking antibiotics to prevent pain, fever, and swelling after tooth removal. This applies to all of these tooth conditions:

  • Severely decayed teeth

  • Gum disease affected teeth

  • Even extractions in sick individuals or those who have low immunity to infection

That is consistent with what we've stated above in that only swelling and severe infections require antibiotics. Removing unhealthy teeth is not an indication for this prescription.


Last but not least, by over prescribing antibiotics, dentists are contributing to antibiotic resistance in bacteria. That causes an immense problem if patients ever need to be hospitalized for other types of infections. The resistance will render most antibiotics useless and the cause would've been from too many visits to the dentist.


According to the CDC (Center for Disease Control), here are some statistics on antibiotic resistance in relation to dentists:

  • Approximately 2 million people become afflicted with antibiotic resistance and 23,000 people die due to it.

  • Dentists prescribe approximately 10% of all outpatient antibiotics!


Therefore, it would be prudent for dentists to limit the prescription to those who truly need it. We as a profession should not be contributing to this crisis and that is the reason why your dentist did not prescribe you antibiotics after a tooth extraction. You simply did not need it!


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About the author: Dr David Chen, DDS

Hello, I'm Dr Chen and I'm an actively practicing dentist in Long Island City, NY. I graduated from Columbia University College of Dental Medicine in 2016 but prior to going to dental school I was already working in the dental field. It's been more than a decade since I first got to know dentistry and let me tell you, time flies by quickly. Since then I've developed a fondness for writing, which is how this all got started!

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Medical Disclaimer:

This blog is purely meant for information purposes and should not be used as medical advice. Each situation in your mouth is unique and complex. It is not possible to give advice nor diagnose any oral conditions based on text nor virtual consultations. The best thing to do is to go in person to see your dentist for an examination and consultation so that you can receive the best care possible.

The purpose of all of this oral health information is to encourage you to see your dentist and to inform you of what you may expect during your visit. Due to the unfortunate nature of dentistry, there isn't really any true home remedies that will get rid of dental problems. Roughly 99.99% of them require in-person intervention by a healthcare professional.

Hint: That is the reason why you can't eliminate seeing dentists in your life!