Looking For A Few Good Dentists

be given for adding a second antibiotic or a combination antibiotic such as Augmentin. Combination therapy has been discouraged in the past but with the increased amount of resistant bacteria to monotherapy it is now more common to prescribe combined therapy such as penicillin or amoxicillin in combination with metronidazole. Monitoring the patient for adverse reactions such as hypersensitivity, developing allergy, antibiotic-associated diarrhea, or more severe antibiotic-associated colitis is imperative.

The ninth principle of appropriate antibiotic use is to use prophylactic antibiotics as currently indicated. In general patients with prosthetic joints do not require prophylactic antibiotics. If they have had surgery and are undergoing invasive dental procedures then consultation with their orthopedic surgeon may be indicated and appropriate. Prophylaxis for prevention of infective endocarditis is indicated in patients with a presence of prosthetic cardiac valves, previous infective endocarditis, unrepaired congenital heart defects and cardiac transplant recipients who developed cardiac valvopathies. Of significance is that if a preoperative antibiotic prophylactic dose is inadvertently missed the medication can be administered up to two hours following the procedure. A review of the American Dental Association guidelines is a great guide in this area.

Some specific suggestions for antibiotics are to rely on the penicillin derivatives whenever possible with cephalosporins as a substitute for the penicillin derivatives if the patient is unable to use these. If they had an allergic reaction that was of a mild nature then this is a reasonable substitute as they are unlikely to have a cross reaction. The only oral cephalosporin that provides coverage for anaerobic bacteria is cefuroxime (Ceftin) and this is an excellent choice. Clindamycin is still a primary choice even though there is an increase in resistant bacteria noted in our community. The quinolones such as ciprofloxacin, levofloxacin, and moxifloxacin are secondary choices because of the potential side effects of tendonitis/tendon rupture, peripheral neuropathies, and central nervous system effects. The quinolones do not have activity against anaerobes and therefore many times need to be used in combination with beta-lactam antibiotics, clindamycin, or metronidazole. The macrolide antibiotics such as azithromycin, clarithromycin, and erythromycin are effective treatment choices for mild odontogenic infections. They may also be used in combination with metronidazole.

Antibiotics are a mainstay of dental treatment but are not a substitute for definitive surgical management. Minor odontogenic infections can be treated effectively with antibiotics and many times with surgery alone but most of the time combined therapy is the treatment of choice.

Dr Ken Baldwin ADA Delegate

Have you ever wondered how to get involved with the UDA at a level you feel you are actually contributing to the future of organized dentistry and our profession? One of the easiest and most enjoyable ways to do this is to become part of a functioning committee that works on things you are passionate about. Currently we are looking for individuals that are passionate about continuing education, love to attend dental meetings to learn new things, and want to be a part of planning and executing the annual UDA Convention by serving on the UDA Annual Convention Committee. We are hoping to have those interested in serving step forward and identify yourself so we don’t have to search you out!

To serve on the committee we are looking for individuals that can commit to approximately 4-5 years working on the committee to scout speakers, plan the yearly program, and help during the convention to see that it runs smoothly. Although this commitment can be less lengthy it does take time to learn from others on the committee in order to be effective. Some committee members are eventually asked to serve as the scientific chair over the UDA Convention and be more intimately involved with the planning and decision process; this usually happens toward the end of their tenure on the committee. Those invited to serve on the committee are asked to:

i. Attend periodic evening planning meetings at the UDA office in Bountiful (often 1x/mo Sept – Jun) ii. Travel to one major dental meeting of their choosing outside of Utah each year to scout speakers, exhibitors, and gather ideas to make our meeting successful (a stipend is paid to offset most or all of the expense for attending this meeting) iii. Accept different assignments leading up to and during the UDA Convention dealing with hosts, exhibitors, etc. iv. Attend the yearly UDA Convention when possible to learn and to help with logistics and assignments during the meeting

Most who have served on this committee have found it to be a fun rewarding opportunity that they look forward to. Much of the current success of our annual convention is due to the input and contributions of these past and present committee members. If you are interested and wish to be considered or want more information please reach out right away to either myself, Jerald Boseman (bosey@aol.com, 801-891-3911 cell), or Dotty Tanner at the UDA (dotty@ uda.org, 801-261-5315).