Individual patient circumstances should be evaluated prior to the use of antibiotics to reduce the risks of certain post-extraction complications. There is evidence that use of antibiotics before and/or after impacted wisdom tooth extraction reduces the risk of infections by 66%, and lowers incidence of dry socket by one third. For every 19 people who are treated with an antibiotic following impacted wisdom tooth removal, one infection is prevented. Use of antibiotics does not seem to have a direct effect on manifestation of fever, swelling, or trismus seven days post-extraction. In the 2021 Cochrane review, 23 randomized control double-blinded experiments were reviewed and, after considering the biased risk associated with these studies, it was concluded that there is moderate overall evidence supporting the routine use of antibiotics in practice in order to reduce risk of infection following a third molar extraction. There are still reasonable concerns remaining regarding the possible adverse effects of indiscriminate antibiotic use in patients. There are also concerns about development of antibiotic resistance which advises against the use of prophylactic antibiotics in practice. Therefore, given that the risks of antibiotics need to be balanced against the possible side effects/adverse effects, antibiotics are not routinely prescribed before or after a dental extraction.
