Updated: Nov 20
If you were prescribed antibiotics after your tooth extraction but you don't take them, there will be an increased risk for complications. It would behoove you to follow the post-surgical aftercare instructions carefully because all of the complications are fairly unpleasant.
However, if you weren't prescribed any antibiotics after your tooth removal, there would be no need to take them. If your dentist didn't think you needed them then you'll most likely be fine without any of the medication.
Consequences of not taking antibiotics
We do not indiscriminately prescribe antibiotics to every patient undergoing extraction of a tooth. We will only give it when we anticipate an increased risk for a post-surgical complication.
In other words, your dentist most likely gave you the prescription because they think you are more likely than not to end up with a problem if you don't take it.
Potential complications from not taking antibiotics:
Dry socket. A dry socket is when a blood clot fails to form in the extraction socket. This condition is extremely painful, so painful that our patients tell us it hurt less before they had their tooth removed!
Gum infection. Immediately after removing the tooth, there will be a large surgical wound in the gums which can develop an infection. This is especially true if the surgical site isn't kept clean and taken care of.
Dental abscess. Sometimes an abscess can develop after the tooth has been taken out. Other times it could be that the infection didn't completely go away after the procedure. The most likely situation for this to happen is if you had facial swelling prior to your procedure.
Conditions with high infection risk
There are certain situations which may warrant taking antibiotics because they are deemed high risk for developing post-op infections.
Diffuse facial swelling. If the reason you're needing an extraction is because the abscess was bad enough to cause swelling, it would be prudent to take antibiotics. Removing the tooth will get rid of most of the infection but it requires taking medication to get rid of the rest. There is a chance it may come back and cause swelling again if you don't.
Surgical extraction. Cracked teeth or impacted wisdom teeth which require surgical removal will need antibiotics. In order for complete removal, a gum flap is often made and jaw bone will need to be drilled away.
History of dry socket. Those that have had a dry socket previously will be more likely to get it again. In this case, it would be an indication to take some amoxicillin afterwards.
Immunocompromised. If your immune system is compromised you will be at greater risk. Most commonly this may be for those who have HIV or AIDS.
If you have any of the above conditions you should highly consider following the antibiotic regimen. Also, diabetics do have a higher risk as well but it isn't an indication to take it.
Benefits of taking antibiotics
When prescribed antibiotics and you take them as instructed, there are many benefits which can be had. Amoxicillin is the most commonly prescribed for all types of extractions, absent of any allergies.
Benefits from taking it:
Reduced risk of infection. Gum infection, jaw bone infection, or any type of socket infection can be prevented with antibacterial medications.
Decreased chance of dry socket. While antibiotics are not purposely prescribed to reduce risk of dry socket, studies have shown that it does help.
If you happen to develop a complication you can be sure that you will need to return to your dentist once more. Simply taking the medication can potentially save you a follow up appointment so you don't need to spend more time there than you'd want to.
Tips for taking antibiotics
Our recommendation is to always take the pill along with your meal because it prevents upset stomachs. Taking it on an empty stomach can sometimes give people digestive issues.
How long do I have to take it for?
When taking antibiotics after a tooth extraction, how long you're supposed to take it for would depend on the regime you were prescribed.
If you were given a 5 day dose then you take it for 5 days.
If you were given a 7 day dose then you take it for 7 days.
Do I have to finish it?
Antibiotics work the most effectively if you finish the entire course. Stopping short may increase the risk of an infection because all it takes is just one bacteria to survive and propagate.
Last but not least, having left over amoxicillin is useless. You can't take expired medication and it wouldn't be a full dose to ward off any infections if you happen to develop something.
What if I weren't prescribed any?
If you weren't given any antibiotics after your extraction, it means that you didn't need it. In other words, your procedure most likely went smoothly and your dentist doesn't anticipate any issues with healing.
Taken another way, it also means that you will probably recover and heal a lot faster since your surgery wasn't as complicated.
Believe it or not, antibiotics aren't always necessary after having a tooth taken out. As a general rule of thumb, routine removal of teeth do not require any because it isn't an indication as a part of the guideline.
Should you take your prescribed antibiotics after the extraction? Definitely take them if your dentist gave you a prescription for it. Doing so will prevent potential complications that may occur such as infections, abscesses, and dry sockets.
Developing a complication will only delay your healing and recovery. Don't you want to return to your normal daily routine instead of eating soft foods all the time? If you value that you should follow the instructions to the T.
Last but not least, if for whatever reason you didn't take any of the amoxicillin and you recovered uneventfully. You should dispose of it. You're not supposed to take expired amoxicillin.