TAMING THE SRU
Taming The SRU - By Max Kletsel - November 03, 2020
..."Overall, although our mouths are rich in microorganisms, the irreversible inflammation of the pulp in the setting of a progress dental cavity is considered to be an inflammatory process to the oral environment, rather than an infectious one. Regardless, antibiotics continue to be prescribed for patients presenting with such symptoms, despite little evidence of their efficacy. In 2000, Nagle et al. established a randomized, double-blinded placebo-controlled study to see if oral penicillin versus placebo helps improve pain over a 7-day period in patients presenting with symptoms of irreversible pulpitis. In this study, a total of 40 adult patients were randomly assigned to either receive penicillin VK (500mg QID) or a placebo control, and were asked to keep a daily diary for tracking their symptoms, as well as number of pain medications taken. After a 7-day period, there was no significant difference in pain ratings or need for pain-relief medications between the two groups.
Evidence such as the study listed above shaped the 2019 recommendations from the American Dental Association, who strongly recommended against prescribing antibiotics for otherwise healthy adults presenting with signs of irreversible pulpitis. So as you head back from the exam room of the patient complaining of tooth pain only with cold, sweet drinks, ask yourself if you really need to place an order for an outpatient antibiotic..."