Postoperative Infection Rates in Minor Oral Surgery Are Closely Linked to Antibiotic Prescribing Practices, With Evidence Showing That Both Underuse and Overuse Can Negatively Impact Patient Outcomes

Background: Minor oral surgical procedures, including third molar extractions and alveoloplasty, are associated with postoperative complications, most notably infection and alveolar osteitis. Clinicians frequently prescribe antibiotics prophylactically, yet their association with infection rates remains controversial. Objective: This review evaluates postoperative infection rates in minor oral surgery and their correlation with antibiotic prescribing patterns, drawing on evidence from randomised controlled trials, systematic reviews and clinical guidelines. Methods: A narrative literature review was conducted of PubMed-indexed studies, including randomised clinical trials, meta-analyses and consensus guidelines, selected to provide a balanced overview of infection incidence, antibiotic efficacy and prescribing trends. Fifty publications were screened; after removal of duplicates and records that could not be verified, 45 unique sources informed the review and 32 are cited here. Results: Reported infection rates in minor oral surgery range from 0.5–5% in routine extractions to 10–15% in impacted third molar surgery. Evidence demonstrates that routine prophylactic antibiotics in healthy patients do not significantly reduce infection rates. Prolonged courses beyond 24 hours offer no added benefit. Selective prophylaxis is effective in high-risk cases, such as immunocompromised patients or procedures exceeding 30–60 minutes. Overprescription contributes to antimicrobial resistance and unnecessary adverse drug reactions. Conclusion: Postoperative infection rates in minor oral surgery are relatively low, and routine antibiotic prophylaxis is not justified in healthy individuals. Judicious, evidence-based prescribing—limited to high-risk scenarios—reduces infection risk while mitigating antimicrobial resistance. Regular audits, adherence to stewardship guidelines and patient education are essential to optimise outcomes.