Antibiotics and painkillers are the most common group of drugs prescribed in dentistry. But most patients have a lesser idea about what the medicines can do and what they can’t.
Let’s start with an example. I had a lady visit me yesterday with a mild swelling on her jaw and a badly decayed tooth. I was confused as to how did it go this bad as her oral hygiene otherwise was decent only. So she said that every time that tooth of hers hurt, she took these medicines and then carried on with her life. Now, this technique would have worked if this was a skin problem or an upset stomach. But, no medicine whatsoever can heal the damaged tooth. Once a tooth is infected, it needs to undergo the required treatment.
Then why do I need to take these medicines?
Antibiotics: We prescribe antibiotics depending on a case to case basis. If the infection is small and we think that your body is capable of taking care of the same, we simply go ahead with the treatment. If the infection has spread to a greater extent, the antibiotics are prescribed depending on the severity of the problem. This is done to assist your body with fighting off the microbes. Irrespective of the situation, it is important that the required dental treatment is performed and the source of infection aka the cause of this infection be taken care of.
Pain killers: Dental pain is horrible. For those who have ever faced it, will agree. In fact, historic data before the advent of these medications have some interesting findings. People have opted for suicide in cases of unbearable dental pain. In order to save you from this trauma, pain killers are prescribed. But they can only stop the sensation of pain, nothing more. Only the removal of the source of the pain can give you a permanent solution.
How do these medications function?
Antibiotics: Different families of drugs have different mechanisms of action. As a general rule, antibiotics work by affecting things that the bacterial cells have and human cells don’t. Below described are the ways how most antibiotics work:
By damaging the bacterial cell walls: Bacteria require a thick cell wall for structural stability (contrary to human cells which just have a thin cell membrane). Antibiotics like beta-lactams, block this process of wall building. Due to the absence of the protective wall, the bacterial contents spill out and they die.
By preventing bacterial protein formation: Major tasks of a bacteria are performed by the protein content within the cell body. Antibiotics like macrolides prevent this protein formation and thereby make the bacteria non-functional.
By hampering the DNA replication: Certain antibiotics like quinolones do not destroy the existing bacteria. But they prevent replication and reproduction of new bacteria by damaging the new DNA. That way, there will be no replication or reproduction of any new bacteria.
Pain-killers: When a part of your body gets injured, there are these special nerve endings that send pain messages to your brain. These drugs interfere with these messages and prevent the brain from acknowledging any sort of pain. This can happen either at the site of the injury, in the spinal cord or in the brain itself; depending on the drug group.
What are the side-effects and risks associated with antibiotics and painkillers?
Too much consumption of these drugs can lead to something called drug resistance. This means, that your body is no more affected by the dose it earlier responded too. So, the dose needs to be increased more and more until it reaches an amount which is not advisable.
Also, some groups of pain killers can develop a certain amount of dependancy.
One more thing to consider is the damage that occurs to the resident bacteria in this process. Antibiotics, on entering the bloodstream not only kill the bad bacteria which are making you sick but also your body’s resident friendly bacteria.
For this very reason, we try to give you medicines only when extremely necessary and start with doses as small as feasible.
How to take antibiotics and painkillers with the least amount of harm caused to the body?
Antibiotics: Take them only when prescribed. Also, once you start taking them, it is important that you complete the entire course of prescription. Even if you start to feel better halfway through, do not stop with your medicines. If you do so, there is a possibility that some microbes are still alive and they will cause reinfection, and with a stronger intensity this time.
Painkillers: Take them for as short a duration as possible. I have seen patients who start to rely on them and delay their treatment. This is an extremely unhealthy practice and should not be followed.
That being said, you can now make informed decisions when it comes to your dental drug prescription.
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