Antibiotics are widely used in dental practice. Yet, many myths surround their use rather than facts.
From the idea that antibiotics can replace dental treatment, to the misconception that they are harmless or are always necessary, these misunderstandings can lead to misuse.
This article explores the most common myths about antibiotics in dentistry and explain the facts behind them.
Antibiotics are not dental pain relievers.
They target bacterial infections, not the pain itself. Antibiotics work by killing or inhibiting the growth of bacteria. In some cases, antibiotics do contribute to pain relief by controlling the infection & thereby lowering the inflammation.¹
Pain is a symptom caused by the inflammatory response of the body's immune system to infection. Painkillers reduce dental pain by blocking pain signals to the brain and lowering inflammation around the affected tooth or gums.
Pain relief is majorly provided by analgesics rather than antibiotics.
How safe are antibiotics?
Research indicates that antibiotics can cause both side effects & allergic reactions. Side effects are relatively common.
Allergic reactions are less common but can be serious. That is why doctors prescribe antibiotics only in cases where its benefits outweigh possible risks.
In many cases side effects of antibiotics remain unnoticed mainly because most common side effects are masked by the effects of infection itself (e.g.: nausea, vomiting). ²
During the initial phase of the treatment, antibiotics kill the weaker bacteria. However, if the medication is discontinued early, the stronger bacteria that survive are left behind. These surviving bacteria multiply, causing the infection to return.
Often, the infection becomes more difficult to treat the second time with the same drug, so doctors may need to prescribe a higher dose or switch to a stronger antibiotic.
The two major risks when antibiotics are stopped early are:
Recurrence of Infection
Antibiotic Resistance
The bacteria exposed to antibiotics can develop special defense mechanisms through mutations. These genetic adaptations make the bacteria resistant to the antibiotics (antibiotic resistance).
The resistant bacteria are called 'superbugs' which will be more difficult to treat
When you use leftover medication or another person’s medicine, you are self-diagnosing yourself which might lead to ineffective treatment, improper dosage, antibiotic misuse or other serious health complications
Antibiotic misuse refers to the inappropriate or unnecessary use of antibiotics. ³
Using the wrong drug or incorrect dosage may delay the correct treatment, allowing infections to worsen. Most critically, it contributes to antibiotic resistance, making infections harder to treat. This misuse also increases the risk of side effects and allergic reactions.
The problem with leftover antibiotics is that it can degrade into toxic byproducts which can cause adverse reactions. Also, another issue that may arise is the contamination of old opened bottles with bacteria or fungi.
Antibiotics can help manage dental infections caused by bacteria such as tooth abscess, but they are not a cure-all.
They prevent severe infections from spreading to other parts of the body in cases of swelling or systemic involvement. The real solution often requires dental procedures to remove the infection source such as root canal or removing teeth.
⁴ There are two types of antibiotics
Bactericidal - Kills bacteria directly (Amoxicillin, metronidazole)
Bacteriostatic - Inhibit bacterial growth & multiplication (Azithromycin, doxycycline)
Antibiotics do not work instantly.
Research suggests that most patients experience a noticeable amount of pain relief and subsiding infection within 3 to 5 days of treatment. It usually takes about a week (5 to 7 days) for the infection to fully clear. ⁵
While antibiotics start working against bacteria from the very first dose, symptom relief usually becomes noticeable only after the medicine reaches an effective concentration in the body.
References
1. Ahmadi, Hanie, Alireza Ebrahimi, and Fatemeh Ahmadi. “Antibiotic Therapy in Dentistry”. International Journal of Dentistry (January 28, 2021). https://pmc.ncbi.nlm.nih.gov/articles/PMC7861949/
2. Samiha Mohsen, James A. Dickinson, and Rajani Somayaji. “Update on the Adverse Effects of Antimicrobial Therapies in Community Practice.” Canadian Family Physician 66, no. 9 (September 2020): 651–659. https://pmc.ncbi.nlm.nih.gov/articles/PMC7491661/
3. Jeevan Nammi, Roshini Pasala, Nikhil Andhe, Ramakanth Vasam, Ausrit Datta Poruri, and Ravishankar Raj Sherikar. “Misuse: An In-Depth Examination of Its Global Consequences and Public Health Challenges.” Cureus 17, no. 6 (June 13, 2025). https://pmc.ncbi.nlm.nih.gov/articles/PMC12256094/
4. Ishak, Angela, Nikolaos Mazonakis, Nikolaos Spernovasilis, Karolina Akinosoglou, and Constantinos Tsioutis.“Bactericidal versus Bacteriostatic Antibacterials: Clinical Significance, Differences and Synergistic Potential in Clinical Practice.” Journal of Antimicrobial Chemotherapy 80, no. 1 (October 29, 2024): 1–17. https://pmc.ncbi.nlm.nih.gov/articles/PMC11695898/
5. Asquau-Liaño, Juan, Svetlana Sadyrbaeva-Dolgova, Sergio Sequera-Arquellada, Coral García-Vallecillos, and Carmen Hidalgo-Tenorio. “Timing in Antibiotic Therapy: When and How to Start, De-escalate and Stop Antibiotic Therapy. Proposals from an Established Antimicrobial Stewardship Program.” Revista Española de Quimioterapia 35, Suppl. 3 (October 24, 2022): 102–107. https://pmc.ncbi.nlm.nih.gov/articles/PMC9717451/
