Although the role of antibiotics in dentistry has become more limited in recent years, there are still many situations that require their use. The antibiotics dentists most often prescribe include Penicillin, Erythromycin, Clindamycin, Tetracycline or their derivatives. These antibiotics can help fight the bacteria associated with most dental infections, but are rarely used as the primary therapy alone. To the contrary, most dental infections are treated surgically, with antibiotics used in an occasional, but important role. When antibiotics are required, Penicillin is usually the first drug prescribed. For patients who are allergic to Penicillin, or have more serious and persistent dental infections, Clindamycin is usually the next drug recommended.
Clindamycin is a highly effective drug when used to fight dental infections. The reason is that Clindamycin is nearly completely absorbed (90%), and penetrates deeply into the soft tissues of the body, as well as bone, where dental infections reside. I use Clindamycin for patients with persistent dental infections, including severe dental abscess with excessive swelling, root canals with prolonged sensitivity and ones that have become re-infected. Clindamycin is also useful for dental infections in patients who are allergic or do not respond to Penicillin.
For most patients, Clindamycin is well tolerated and highly effective. There are, however, potential side effects associated with the drug. Clindamycin has been shown to cause a potentially dangerous form of colitis, called pseudomembranous colitis, in a small percentage of patients. For this reason, Clindamycin should be stopped immediately if any diarrhea develops. Clindamycin should also not be prescribed for patients with a history of gastrointestinal disease, especially colitis, without the dentist first consulting with the patient's family doctor or medical specialist. Clindamycin sometimes gets a bad rap from members of the dental community because of its potential for pseudomembranous colitis, even though this problem can result from nearly all antibiotics. Dentists should always exercise caution when prescribing antibiotics, and monitor their patients closely for side effects. Even so, research and clinical experience show that the prudent use of Clindamycin is generally safe and very effective for treating dental infections.