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Antibiotics

Antibiotics in Dentistry: What Examiners Want

A predictable, examiner-friendly method to approach antibiotic questions safely.

Quick Answers

When should antibiotics be prescribed?

Only when there is infection with systemic involvement, spreading infection, or when drainage is not possible.

What are the first-line antibiotics?

Amoxicillin or Penicillin V; metronidazole for anaerobic coverage or penicillin allergy alternatives.

Do you prescribe for pulpitis?

No. Irreversible pulpitis and most dental pain do NOT require antibiotics.

What do examiners want to hear?

Clear indications, correct drug choice, correct dose, safety advice, and when NOT to prescribe.

1. Why antibiotics matter in exams

Antibiotic misuse is a major global issue. Examiners across ORE, ADC, NDEB, NBDE/INBDE, and MFDS focus heavily on correct indications and confident refusal of unnecessary antibiotics.

Your goal is not to list every antibiotic—it’s to show safe, guideline-based clinical judgment.

2. The only three true indications in dentistry

Examiners love this list

1. Systemic involvement – fever, malaise, lymphadenopathy.
2. Spreading infection – cellulitis, fascial space involvement, trismus.
3. When local drainage is impossible – no access for I&D, difficulty accessing the source.

If your answer fits one of these, you’re safe. If not, the correct exam answer is usually: “No antibiotics indicated; treat the cause.”

3. First-line antibiotics and common doses

Know the key drugs and keep your answers short:

  • Amoxicillin: 500 mg TID for 5 days.
  • Penicillin V: 500 mg QID for 5 days.
  • Metronidazole: 400 mg TID for 5 days (anaerobes / penicillin allergy).
  • Severe infections: combine amoxicillin + metronidazole when clinically appropriate.

Avoid listing unnecessary antibiotics—examiners want clarity, not a pharmacy catalogue.

4. When NOT to prescribe (high-yield exam points)

Most questions award marks for knowing when antibiotics are NOT needed:

  • Irreversible pulpitis (no swelling, no fever).
  • Symptomatic apical periodontitis without systemic signs.
  • Localised acute abscess that can be drained.
  • Dry socket.
  • Pericoronitis without systemic involvement.
  • Routine extractions or clean surgical procedures.

Say this clearly: “Antibiotics are not indicated; I would manage with local measures and analgesics.”

5. Red-flag scenarios examiners expect you to mention

These phrases score marks because they show safety awareness:

  • “I would assess airway, breathing, and swallowing difficulty.”
  • “If there is trismus or floor-of-mouth elevation, urgent referral is indicated.”
  • “Failure to respond to antibiotics within 48 hours requires review.”

6. Sample exam-style answers

Example: Localised acute abscess

1. Drain via tooth or soft tissue.
2. Analgesics and address cause (RCT/extraction).
3. No antibiotics unless systemic symptoms or spreading infection.
4. Review within 48 hours if symptoms worsen.

Example: Cellulitis with fever

1. Assess airway + facial space involvement.
2. Start amoxicillin ± metronidazole.
3. Arrange urgent drainage.
4. Red-flag education and follow-up.

7. Phrases examiners want to hear

  • “Antibiotics are an adjunct, not the primary treatment.”
  • “I will prioritise drainage and removal of the cause.”
  • “I will review in 48 hours to assess response.”
  • “I would check medical history, allergies, and drug interactions.”

8. How to study antibiotics fast

5-minute exam routine

1. Memorise the three indications.
2. Memorise first-line drugs + doses.
3. Memorise top “no antibiotic” scenarios.
4. Practise one case per day (endo, perio, swelling, trauma).
5. Repeat until automatic.

9. How DentAIstudy helps

DentAIstudy makes antibiotic revision simple by generating short, examiner-style points for any scenario.

  • Instant summaries of indications, contraindications, and doses.
  • Clear “no antibiotic” explanations for common OSCE traps.
  • Red-flag identification for swelling and infection cases.
  • Sample structured answers you can rehearse for viva exams.

Try Study Builder →

References

  • Faculty of General Dental Practice (UK). FGDP Antimicrobial Prescribing Guidelines.
  • Scottish Dental Clinical Effectiveness Programme (SDCEP). Drug Prescribing for Dentistry.
  • American Association of Endodontists. Guidelines for Antibiotic Use in Endodontics.
  • British National Formulary (BNF). Latest edition.