Failure to Administer Antibiotics After Tooth Extraction Leads to Infection
This special care dentistry case takes place in Nevada and involves a male patient who had a long history of extremely poor dental hygiene.
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Case Overview
Questions to the Oral Surgery expert and their responses
Based off of the case summary do you believe that the dentist may have acted below the standard level of care when he did not prescribe antibiotics immediately after the tooth removal even though he had an extensive history of poor dental hygiene?
The indications for antibiotic administration for third molar removal are impaction, pericoronitis, swelling, trismus, lymphadenopathy, and fever. If the patient had any of these, antibiotic administration was indicated. If the patient states any of these were present, then there may be a question of fact over the dentist's testimony. Poor oral hygiene and smoking do not in themselves justify antibiotic administration. Inappropriate referral is the likely breach of the standard of care here, with possibly failure to prescribe an antibiotic in the conditions described above.
About the expert
This is a nationally recognized expert in OMFS with published, grant-funded, award winning research in the field of severe odontogenic infections. He has authored chapters on infection in most general dentistry and oral and maxillofacial surgery textbooks, and has been appointed to high ranking clinical and academic positions at among the nation's top dental institutions.

E-000943
Specialties:
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