Randomized controlled trial comparing antibiotics to placebo for single simple dental extractions in diabetic patients

Type 2 diabetes mellitus is a prevalent chronic disease in the adult population, and its complications include delayed wound healing. Dentists often have to decide whether to prescribe antibiotics for tooth extractions in these patients. Aim: To compare post-surgical variables for single simple dental extractions from controlled type 2 diabetic patients, administering either antibiotic or placebo. Materials and Method: The study included controlled type 2 diabetic patients requiring a single dental extraction (tooth non-impacted and without acute infection) from April 2021 to May 2023. They were randomized to amoxicillin or placebo prior to surgery. Extractions were performed without raising flaps or bone removal and took no longer than 45 minutes. Before surgery, blood glucose was measured. Age, gender, tooth to be extracted, surgery time, pain, bleeding, trismus, alveolar osteitis, infection, healing, gastric alterations, and number of analgesics taken were evaluated. Patients were checked by telephone call 2 and 14 days after the procedure, and in person after 7 days during the suture removal visit. The data were analyzed using Chi-square, Fisher’s exact or Mann-Whitney U tests, as appropriate (p<0.05, significant). Results: The analysis included 56 extractions in 56 patients, aged 41 to 81 years (mean SD = 59 +/- 9). During the telephone call at 2 days, no significant difference was found between groups for pain, trismus, edema, hemorrhage, gastric alterations, or analgesics taken. At the clinical checkup at 7 days, no significant difference was found between groups for pain, edema, trismus, alveolar osteitis, hemorrhage, delayed healing, or gastric alteration; but there was a significant difference in the number of analgesics taken (p < 0.05), which was higher in the amoxicillin group. During the second telephone call at 14 days, no significant difference was found between groups for pain, edema, trismus, hemorrhage, or gastric alterations; but there was a difference in the number of analgesics taken (p < 0.05). Patients in the amoxicillin group took more pain relievers. No case of alveolar osteitis or local or systemic infection was recorded in either group. No patient required additional treatment or hospitalization. Conclusion: No significant difference was found for alveolar osteitis, infection, or healing delay after single simple dental extractions in controlled type 2 diabetics, whether they took amoxicillin or placebo. The data from the present study suggest that antibiotic medication in these cases would not be necessary.