Antibiotics for a Tooth Infection, Dental Implant, Bone Graft

Antibiotics for a Tooth Infection, Dental Implant, Bone Graft

Antibiotics for a Tooth Infection, Dental Implant, Bone Graft

In this short, but highly informative video, I review some of the common truths and misconceptions about antibiotics in relationship to tooth infections, dental implants and bone grafting.

Are Antibiotics Required For Implants?

Use of antibiotics should be judicious and carefully thought out.  Just because you have an “infection” in your tooth, it does not mean you need an antibiotic.  Also, not all “infections” are actually infections.  Not all infections can be cured by antibiotics alone.

In fact if you are allergic to penicillin please click this link.  Being allergic to penicillin carries more risk for implants and bone grafting.  Amoxicillin is the most common antibiotic for a tooth infection.

Antibiotics are commonly needed for procedures that involved cutting through bone or addition of bone graft materials.  There is a limited supply of new blood vessels that can get your natural immune system’s protection in the first few days following a significant procedures such as a surgical extraction, a bone graft, sinus graft, apicoectomy and dental implants.

Antibiotics are extremely helpful in many situations.  I also discuss common questions such as antibiotic resistance and what happens with common stomach issues and what to do about them.

I think you will find this video helpful.  Please feel free to ask questions below.

Ramsey A. Amin, D.D.S.
Diplomate of the American Board of Oral Implantology /Implant Dentistry
Fellow-American Academy of Implant Dentistry
Burbank, California


Video Transcription Antibiotics for Implants:

Hello Ramsey Amin, DDS here. Antibiotics are always a big topic of discussion and can antibiotics help my tooth? Do I need antibiotics before an extraction, after an extraction, before a bone graft, after a bone graft? There’s so many different times that we may need the benefit of antibiotics and perhaps sometimes we do not. Most often I receive a question online about a failing tooth that you were told is infected and needs to be removed. And a question arises, well, should I be on antibiotics? Most infections that are within teeth are oftentimes at the apex or the end of the root. They are oftentimes around a root canal tooth that is treatment plan for extraction because it’s fractured or a crown can not be made for it. And these infections, quote unquote, or inflammation are chronic in nature typically.

If your face isn’t swollen, there’s no pus draining, you don’t have a limited opening, a bad taste in your mouth, a fever, chills, night sweats. Most of the time antibiotics are not necessary until the tooth is removed and especially if a bone graft or a dental implant is placed at the same time. The antibiotics can be placed either in the IV, during IV sedation or taken orally by mouth as pills. But antibiotics are not a cure all. They do help to reduce bacterial counts and reduce infections that can occur. Infections can and do occur and just because you are on an antibiotic doesn’t mean that you will not get an infection. Most antibiotics have some degree of what we call broad spectrum nature where they do kill some bacteria of all different types. Amoxicillin and perhaps clindamycin are the most common. There are others such as augmentin, and Z packs, and other very strong medications such as metronidazole, flagyl, vancomycin ,that are not always necessary.

Some infections do get, or can get out of hand, depends on your own immune system. Other factors, do you take medications that can impair your immune system? Do you have HIV? There are many things that can cause antibiotics not to work and infections to get worse. If an infection gets worse, oftentimes the entire family of antibiotic needs to be switched from the amoxicillin, penicillin family to a clindamycin family perhaps, or what’s called a culture and sensitivity is done in order to determine, well, what kind of bacteria are here? Do we need to determined by a microbiological culture, basically some and grow them in a Petri dish and expose them to different antibiotics and see which one works best against this infection.

But antibiotics are needed for some patients. They do have side effects of course. They should be used conservatively, not too liberally. And they can also cause issues within the gut. Oftentimes a dose of probiotics or just simple daily four ounces of yogurt with acidophilus can help reduce the chance of getting a upset stomach from antibiotics. Antibiotics are always absorbed better with food than without food typically. But just keep in mind the antibiotics are not always needed. Your dentist is all ultimately going to tell you whether you need them or not and just be sure to follow through on schedule all the way through until they’re complete if you are placed on an antibiotic.

Sometimes only a preoperative antibiotic is needed, just a single dose at the beginning of an implant or a bone graft surgery. That’s typically done by IV in the IV sedation in the arm. A dose of antibiotics can be given then and sometimes there is not need for followup, but again, they are not always necessary on all extractions. Definitely on larger bone grafts and multiple implants. Even most single implants will require antibiotic therapy. They do not cure failing apicoectomy teeth or failing root canal teeth. They simply provide a patch or a temporary bandaid for seven to 21 days, perhaps, until definitive treatment can be done and it be taken care of. Thank you so much for watching.

170 Comments

  1. Lennard

    Hi Dr. Amin,

    I recently went to the dentist and she had to do scaling on it to clean off the stain and calculus on the tooth. But I recently realized that the tooth has become more narrow, possibly due to the scaling that the dentist did.

    Because the tooth has become quite thin, would it be in danger of falling out in future? Here is the link of the picture for you to look at https://i.imgur.com/CMp2FpF.jpg

    Thank you Dr. Amin.

    August 12, 2020 at 9:37 am Reply
  2. Christina

    Hello doctor,
    I first want to say how impressed I am with your kindness and expertise in answering so many questions.
    Secondly, I’ll be getting a bottom tooth, molar, extracted and an implant placed in approximately 3 weeks. My concern is that I have severe osteoporosis, not on any meds for it, and am concerned graft won’t take. My surgeon doesn’t feel it will be an issue. Just wondering what your experience is on this matter. Also, just like many people, absolutely dreading the upcoming round of antibiotics. And I understand the need, but have been on five rounds of antibiotics already this year for a complicated UTT.

    July 5, 2020 at 11:24 am Reply
    1. Ramsey Amin
      July 11, 2020 at 10:19 pm Reply
  3. 7 days post implant surgery no grafts (2 jaw implants). No pain after day three. Day 5 pain returned. Advil takes care of pain. Still swelling at one implant site. Was removed from antibiotics due to allergic reaction on day 5 of of taking. Started 2 days prior to surgery. Not replaced with a different antibiotic. I was told my mouth was real clean and neccessary. Continue baking soda rinses 4 times daily. Is this returned pain normal part of the healing process or should I be concerned of an infection?

    June 28, 2020 at 2:42 pm Reply
    1. Ramsey Amin

      If you are not pain-free within 10 days you should go back onto an antibiotic

      July 4, 2020 at 7:55 pm Reply
  4. Lennard

    Hi Dr,

    I had gone through bone grafting + implant surgery in February 2020. A part of my gums is, however, still whitish.

    The picture can be viewed at https://i.imgur.com/pbXLkLX.jpg

    Why is the gums still whitish? Does it mean it will forever be white and never revert back to its pinkish colour?

    Thank you Dr.

    May 31, 2020 at 5:26 pm Reply
    1. Ramsey Amin

      Blurry picture but looks good overall. Way better than a dark pink color

      June 4, 2020 at 12:17 am Reply
  5. Bryan

    Had apiectomy over a year ago and the tooth is finally feeling stable and secure. I was fine all day. I finish eating a few min ago and noticed a little irritation in my lip. Like a swollen feeling. I’ve been used to strange feelings after food, some tingling etc… But I’d always examine and be fine. Today I do the same and It’s little white dots right on the stitch line where the incision was. No pain, no loose feeling in the tooth, nothing. Just those small white dots right on the scar line

    May 5, 2020 at 4:01 am Reply
  6. Meagan C

    Hello, thank you for making this thread public. I had an onlay bone graft 3 weeks ago (sourced from my lower jaw) in the area of #12 and #13. I was genetically missing those teeth. About 1 1/2 weeks post surgery, I developed swollen areas that were leaking graft material and a clear/yellow fluid. I was placed on an additional round of clindamycin and a chlorhexidine rinse. I was already on clindamycin for 10 days post surgery. I have been on the second round of clindamycin for 1 1/2 weeks now and little to no improvement. In fact I have an additional area of concern now as originally I had 2 areas or “bubbles” in the skin that were leaking, now I have 3. Is this indeed a sign of continued infection and could it be possible I’m simply not responding to the clindamycin? Thanks in advance for any thoughts.

    April 1, 2020 at 7:00 pm Reply
    1. Ramsey Amin

      Is the bone showing?? If so it needs to be removed in order to get the gum to cover over. Clindamycin should be switched to something else or do a culture of still infected after 2-3 weeks

      April 23, 2020 at 3:33 am Reply
    2. Bryan

      I’m having the same issue with an almost identical story line. Had apiectomy over a year ago and the tooth is finally feeling stable and secure. I was fine all day. I finish eating a few min ago and noticed a little irritation in my lip. Like a swollen feeling. I’ve been used to strange feelings after food, some tingling etc… But I’d always examine and be fine. Today I do the same and It’s little white dots right on the stitch line where the incision was. No pain, no loose feeling in the tooth, nothing. Just those small white dots right on the scar line

      May 5, 2020 at 4:00 am Reply
  7. Lennard

    Hi Dr,

    I underwent bone grafting + 2 implants drilled into my jawbone about 10 days ago. The surgical site seems to be subsiding day by day, gradually. The stitches are still in place.

    But sometimes, I am able to feel there is a mild, pulsating sensation around the top of my gums, beside the tooth.

    I wonder if this is a sign that the bone graft is failing? I don’t feel any pain in the jawbone where the implants are placed.

    Or I wonder if it’s just because the stitch has been tied tightly around the tooth, leading me to feel that pulsating sensation? Is it just blood flow that is causing it?

    Another question, am I able to resume cycling?

    Thank you.

    February 25, 2020 at 5:26 am Reply
    1. Ramsey Amin

      cycle!

      But take it easy a bit. This would be considered normal during this early stage of healing.

      March 12, 2020 at 2:47 am Reply
  8. Kristine Alexandria

    Dear Dr. Amin; hope you can offer some advice.
    I had an implant placed a week ago in #6 (upper right canine) and have been experiencing numbness in the front two teeth next to it since. The Implant Specialist tells me it’s normal, there being many nerve branches in the area, and it should heal fine.
    However, as of yesterday I started having dull pain in the numb teeth, feels like the sensation is trying to come back. More concerning is the fact that tooth #7 has become loose and slightly angled in the socket. (It had a rootcanal/crown placed 6 years ago in case that matters.)

    My question is:
    1. What would cause tooth #7 to become loose after an implant was placed next to it? Should I be concerned of loosing it?
    There is swelling in the area, I took antibiotics only for the first 3 days since I’m allergic to pencicillin and clindamycin and it seemed to be healing well.

    2. I’m sure it would help to place me back on antibiotics. What alternatives to clindamycin would you recommend?

    Thank you for taking the time to read this and hope you have some advice for me. Many thanks!

    February 15, 2020 at 3:18 pm Reply
    1. Ramsey Amin

      The bite needs to be adjusted on the tooth is loose. It is likely forming a condition called fremitus which is easy to deal with. Sometimes the inflammation from the surgery can cause this on the tooth with a root canal. As for antibiotics you can try a new generation cephalosporin

      February 21, 2020 at 6:34 am Reply
      1. Kristine Alexandria

        Thank you so much for your response. It’s very helpful!

        March 12, 2020 at 6:48 am Reply
  9. Rob G

    I just had an extraction and bone graft on #14 after continuing pain post root canal and what turned out to be a cracked root. My oral surgeon prescribed doxycycline. Is it absolutely necessary to take this prescription? I just finished 3 courses of antibiotics and am nervous about asking more. Also, there is info that doxycycline interacts with the PPI I take, Pantoprazole. Thanks!

    November 13, 2019 at 10:24 pm Reply
    1. Ramsey Amin

      bone grafts are dead. Your body has to bring it to life before it gets infected. It is case by case

      November 14, 2019 at 12:17 am Reply
    2. Ramsey Amin

      bone grafts are dead. Your body has to bring it to life before it gets infected. It is case by case.

      November 14, 2019 at 12:28 am Reply
    3. Hakar

      Hello there,
      I really need your advise Dr. Amin

      I had a moral # 3 pulled out on 10/31/19, and the oral surgeon recommended I do the bone graft same day, and I did. Since then I been having so much pain, and I went back to her multiple times and she kept saying no the pain is not coming from there. Then I said to myself this is it I can not take it, so I called her office and I told them, I want the bone graft to be removed, I went in and saw her, and she said lets get a second opinion I will send you over to another oral surgeon who is more experienced to take a look and when he did the CT he found 2 spots in the bone graft that was infected. He said I will put you on clindymcin for 2 weeks then we will follow up. The very first day of taking it I felt better, and I was pain free and right before I finished the medication 2 days prior my pain started again, but this time is like 6-7 out of 10, before was 9-10 out of 10. I went back to the oral surgeon who prescribed me the medication and he touched around my gum area and he said you are much better. I said can we do a CT to make sure its gone, and he said no, because it takes 3 months for the infection to disappear and see the result of the CT. So he said come back in 3 months. But the problem here, is I can not live with this pain for 3 months, its just too much. Any advise? I went to a neurologist and we though I had trigeminal neuroglia and I didn’t have that. and my neurologist said he doesn’t know what to prescribe me if the pain the caused by the implant. I need your help and advise please! thank you so much

      January 21, 2020 at 5:51 pm Reply
      1. Ramsey Amin

        Extremely unlikely that it is the graft. Go see an Endodontist. It is likely another tooth in that area

        January 22, 2020 at 6:16 am Reply
      2. Ramsey Amin

        Abnormal for sure. Also check for nerve impingement but likely another tooth causing this. Rarely this can be osteomyelitis

        January 22, 2020 at 6:20 am Reply
      3. Ramsey Amin

        I doubt it if any of that. It might be another tooth or your bike needs to be adjusted for fremitus. That means your teeth are moving a bit when you bite hard. I would suggest you see an endodontist to evaluate your other teeth in the area.

        February 9, 2020 at 1:14 am Reply
  10. Tanya

    I would love your input!! I had a dental implant placed 4 days ago on an area that had a well healed bone graft according to CT results.
    I had some pain at first but the throbbing pain started 2 days later. My doctor called in Amox 500mg on the 3rd day. I’ve been on the antibiotic >24 hrs with no relief of the throbbing pain. Ibuprofen 800 mg helps to take the pain away a little but not entirely. My questions are:
    1) Do I risk losing the implant?
    2) Should I be prescribed a different antibiotic or am I not giving it enough time?

    Thank you in advance!!

    October 6, 2019 at 11:22 pm Reply
    1. Ramsey Amin

      It is a bit early to conclude anything. Give it a few days and hopefully it will get better. 🙏

      It usually takes about 2-3 days for the antibiotics to work

      October 7, 2019 at 5:33 am Reply
      1. Tanya

        Thank you for responding!! I will try my best to be patient.

        October 7, 2019 at 2:38 pm Reply
  11. VH

    Hi Dr. Amin,
    I had #5 extracted today….it’s shown to have a short blunt root for 40+ years(I’m 56)….I suspect a result of orthodontia back in the day…..3 weeks it sort of let go and was super loose.

    Anyway, the peridontist refers to the bone loss (seen on xray) as “infection” and of course prescribed Amoxicillian. I have a desire to avoid antibiotics but I don’t want to make matters worse! Is this (lack of density around a tooth that was “loose” for 40+years) a true infection or is the bone loss called that in the dental professional world. Is the bone actually “infected” in these general situations? TIA!!

    May 23, 2019 at 10:47 pm Reply
    1. Ramsey Amin

      if you don’t have pain antibiotics are likely unnecessary unless you’re having the implant or the bone graft done. Bone loss around teeth typically is a low-grade chronic infection that takes years but antibiotics will not treat it. Antibiotics are important for more substantial dental implants and bone grafting procedures

      May 30, 2019 at 3:37 am Reply
  12. Becca R.

    This page is wonderful and I am so glad I found it, I hope you can answer my question. I am 8 weeks post op. I had a root canal on my top left fail because of infection around the root tip. The day of surgery they extracted the tooth, put in the first part of the implant, and did a bone graft. I was put on 10 days of antibiotics. At my 3 week check up and removal of stitches I still had pain in the upper gum around the implant and would feel pressure / discomfort in my jaw around it as well. The doctor took xrays and said it looked fine, but I went back a week later with no improvements so they put me on a second 10 day course of antibiotics. The discomfort and pressure I was having did seem to get better, but not quite two weeks after finishing the 2nd round of antibiotics the pain in my upper gums around the implant returned as well as very slight swelling in the gum/roof of my mouth. After a few more days the pressure /discomfort in my jaw began to return also so I went to my dentist again. He noted a slightly dark area around the implant during xrays that was “too slight to know for sure” and decided to put me on a third round of antibiotics. At this point my stomach is in ruins, and day 4 into this round of antibiotics the pain is still present. I am taking a probiotic from the pharmacist to help with my stomach, and I’ve scheduled a 3d scan with my dentist. I’m wondering even though the xrays dont show solid signs of infection could the implant be failing? Should I be feeling this pain and radiating discomfort 8 weeks post op? I’m afraid of what the next step might be.

    March 18, 2019 at 10:50 pm Reply
    1. RamseyAminDDS

      Ugh. It might not be taking. Be careful on meds that long. I would suggest florastor as it is a yeast based probiotic.

      Hopefully you are not on clindamycin for that long.

      😢

      March 19, 2019 at 5:38 am Reply
      1. Becca R.

        Thank you so much for answering! The first round was amoxicillin for 10 days, the second was Augmentin 500mg twice a day for 10 days.. The third round I’m currently on is Clindamycin and its 300 mg 4 times a day for 7 days. I’m already on day 5 so I’ll of course finish it. I am afraid if it doesn’t take and they do have to remove the implant, or do another bone graft will they put me on a 4th round of antibiotics? Should I take it?

        March 19, 2019 at 3:29 pm Reply
        1. RamseyAminDDS

          Ask them to add Flagyl plus the other antibiotic if you can take it.
          Let me know how it works out.

          March 19, 2019 at 3:32 pm Reply
          1. Becca R.

            To be clear should I ask them to add the Flagyl now, or if they end up having to remove the implant? What other antibiotic? Sorry I just want to be sure I understand! 🙂

            March 19, 2019 at 3:51 pm
          2. RamseyAminDDS

            again I have not seen you, I don’t know your medical history and I have no idea what your bone and implant look like. I have to make a lot of assumptions. I would not remove an implant unless it has been problematic for a month generally speaking. How is it going know? Did they put you on Flagyl?

            March 25, 2019 at 4:39 am
          3. Becca R.

            My update is a disappointing one. They did not put me on Flagyl.. I have been off antibiotics for almost three weeks. I am still taking daily probiotics and my stomach is better but still not normal. The pain and discomfort is still present in my implant. The 3D xray showed nothing and my dentists are stumped. I am now basically waiting things out to see if they improve or worsen. I’m unsure how long I should tolerate the pain before going back in, or if they will know how to help me if I do go in. Thank you very very much for the advice you have given, I wish I lived near by to get your expert opinion in person! You are a blessing to the people you help!

            April 9, 2019 at 3:15 am
          4. Becca R.

            UPDATE: I got a second opinion from a specialists as my pain got unbearable. The Implant and bone graft around it were infected and unfortunately so was my sinus. I had a second surgery to have the implant removed, my sinus cleaned out, and new bone graft placed. I am mostly pain free now after a nearly 4 month long ordeal! For those reading this blog always see a specialist like Dr. Ramsey Amin if you can. Don’t be afraid of second opinions especially if you keep getting prescribed antibiotics over and over again with no success. Thank you again!

            May 22, 2019 at 3:13 pm
          5. Ramsey Amin

            thank you for your kind words. I’m glad you doing much better. I really appreciate the follow-up!

            May 22, 2019 at 11:48 pm
  13. Candace

    I am so glad I came upon this post. I just had a bone block placed (failed root canal, extraction, bone graft, now block) and was given IV antibiotics following the procedure and am now on clindamycin for 15 days. This seems like way too long to be on this medication and I really do not want to end up in the hospital with c. dif. At this point I am already 7 days post-op and it wouldn’t be worth changing antibiotics but I feel like a 7-10 day course is sufficient. Help?!

    March 5, 2019 at 4:55 am Reply
    1. RamseyAminDDS

      I would suggest taking a probiotic that is yeast based at the same time while you take clindamycin. “Florastor” is over-the-counter and works great!! These types of bone graft take longer to get blood so so antibiotics are often taken for longer duration. I’m assuming you are on clindamycin because you are allergic to penicillin and cephalosporins

      also eat about 4 ounces of yogurt a day

      March 7, 2019 at 12:16 am Reply
  14. Alex vS

    Great effort you’ve made to respond to people’s comments. My question is how to determine whether antibiotics should be prescribed for placement of bone graft and/or implant when there is no sign of infection, i.e. preventatively.

    Context: I have lost 5 teeth and am having bone-grafts and implants placed. Sometimes bone graft first, and then implant 4 months later, sometimes both same time. This is being done in Singapore, besides the astronomic cost, my concern is they prescribe me antibiotics for 5-days each time and side effects render me useless, whether augmentin or Clindamycin (I’m heavily allergic to all sulfer based antibiotics, so that no option).

    In the scientific literature, I see there is evndience preventative antibiotics result in lower % infections when implants are placed. Also read that common conception antibiotics should always continued to full prescribed number of days, despite no sign of infection, has been challenged.

    Had bone graft placed 2 days ago and considering stopping antibiotics now. Everything seems fine (I have had many procedures so have some experience) the only “problem” being the antibiotics prevent me from being able to work, and I have so many of these staged procedures (extraction, bone-graft, implant etc…) it’s like the 7th antibiotic cure I’m taking in 12 months … and all only preventatively …. welcome your thoughts…

    January 20, 2019 at 1:05 am Reply
    1. RamseyAminDDS

      I would have all the work done in one visit with one round of antibiotics. Maybe 2 visits max.

      bone Tissue banks in the USA follow stringent sterilization guidelines. Not sure about Singapore bone source.

      January 22, 2019 at 3:40 pm Reply
  15. Lisa chen

    Dear Dr.Amin,
    I had my #3 extracted and grafted 4 months ago due to failure of root canal (17 year old). I took 7 days ammoxiciline for the procedure. After 9 weeks there was no sign of gum healing and the bone particles covered with yellow stuff kept falling out , the surgical site was still red, and the surface was kind of painful, especially when the partial stuck out of the surface. and it was sore when I touched the gum on the cheek side with Qtip. So my dentist decided to remove the top layer ( about 3 mm) of the bone particle and re- covered the site with collagen and membrane with at least 12 stitches. This time he did not prescribe me antibiotics. He checked the site on day 9 and removed the stiches on day 16. This time the surgical site was partially pink, but three small spots were still red. But I started to feel itchy on the surgical site since day 10. At first I thought the itchiness was a good sign. But the itchiness persisted and I couldn’t fall sleep. So on day 21 my dentist prescribed some steroids solution for me to apply on the surgical site. It helped to suppress the itchiness at first, now it is not as effective as before after using it for over a month. I can also feel the itchiness and a kind of sore when I apply the medicine on the gum on the surgical site. And I can see that the gum is still not completely healed. Is there an infection underneath the gum? Is there anyway to stop the itchiness? Please help me Dr Amin. It is so itchy that I cannot sleep. Thank you in advance!

    January 10, 2019 at 5:47 am Reply
    1. RamseyAminDDS

      Are you allergic to
      Any foods?

      There is a remote
      Chance you are
      Allergic to the membrane or sutures.

      This is very very rare. Please reply.

      January 10, 2019 at 6:00 am Reply
      1. Lisa Chen

        Thank you Dr. Amin.
        I don’t have any food allergic history. Although I am moderately allergic to cat and pollen etc. my dentist ordered biopsy when he removed the top layer the result returned normal, no infection nor allergies found. He did switch to different membrane and thread for the second surgery.

        January 10, 2019 at 2:09 pm Reply
        1. Lisa

          Dr. Amin,
          Is there any solution to address the itchiness ? Or it has to be resolved by another surgery?
          Thanks!

          January 11, 2019 at 10:07 pm Reply
          1. RamseyAminDDS

            very very strange…hopefully this resolves on its own

            January 13, 2019 at 6:48 am
  16. Jane D.

    Hi Dr Amin,
    I had a tooth extraction (what was left of my tooth) with bone graft done yesterday. The tooth had already fallen off many years ago (previously had a root canal with crown which came off and stayed off) and I didn’t plan on getting an implant until now. So there wasn’t really any infection to my knowledge (never had any pain or swelling at the site). The dentist yesterday told me that she placed the bone graft and put in a suture and asked that I start on a 10-day course of amoxicillin. I was unaware that I needed to be on antibiotics after the procedure, and it sort of upset me because I’m currently breastfeeding a 4 month old. I know that the medication is generally safe while breastfeeding but I’d rather not expose her for various reasons. Do I need to be on antibiotics? And if so, is a 10-day course really necessary? I’m generally very healthy and don’t smoke.
    Thank you,
    Jane D.

    December 12, 2018 at 3:39 pm Reply
    1. RamseyAminDDS

      UGH…. It sounds like your dentist does not know you very well. I personally would have delayed until your baby was older. Please watch the video because it discusses how not all grafts need antibiotics but most do. It really depends on the number of walls and the technique of the graft. This is a discussion you should have with a dentist. Fortunately young and healthy mothers tend to heal well.

      December 18, 2018 at 2:13 am Reply
  17. Hana

    Hi Dr. Amin,

    Thanks so much for touching on this topic. I haven’t been able to find any dentists who are aware of this issue so I was happy to find this thread. (I’ve been putting off a tooth extraction that seems to be infected in order to avoid antibiotics while trying to heal from pretty severe stomach issues.)

    I was wondering:

    1. How soon after an extraction does a bone graft need to be performed to avoid bone loss/gum recession?

    2. Do you recommend any natural “antibiotics” following tooth extractions and bone grafts? Or are conventional antibiotics for these procedures absolutely necessary?

    I’d really appreciate your input. Thanks again!

    November 28, 2018 at 5:14 am Reply
    1. RamseyAminDDS

      Graft is best done at time of extraction in most cases. There are no real natural antibiotics that would have a systemic effect

      December 5, 2018 at 6:02 am Reply
  18. Danny

    Hi-I had tooth #31 extracted today. I did not have a bone graph…there was also infection.I am now thinking that I should have….what are my options for an implant since i didn’t have the bone graph done at the same time. Can I get it done post extraction?

    November 13, 2018 at 2:55 am Reply
    1. RamseyAminDDS

      yes definitely. Let it heal for about 4-6 months and go ahead and get the workup for the single-tooth implant

      November 15, 2018 at 1:59 am Reply
  19. Sabrina Hoffman

    Hi,

    I hade a failed root canal and api on #9 and the tooth was extracted in June. Additionally, I had a crack in root canal #10. My oral surgeon extracted #10, did bone grafting and gum grafting 11 days ago. About 5 days ago pinkish/yellowish discharge started coming from the area when I smile. He started me on amoxicillian yesterday. Now the area is discharge thin yellown fluid. Should I be concerned and does the graft need to be removed?

    September 3, 2018 at 2:47 pm Reply
    1. RamseyAminDDS

      Give it time before jumping to that conclusion.

      September 3, 2018 at 8:44 pm Reply
  20. Kristi

    Thank you so much for continuing to answer questions on this thread, it is so helpful!

    Here’s mine: I’m almost done with a 28-pill prescription of clindamycin for an infection in my lower left molar, 2nd from back. This tooth has a deep mercury filling from at least 20 yrs ago and part of the tooth broke 12+ months ago.
    My dentist recommended a root canal or extraction and I did a consult with the nearest endo specialist, who agreed.
    His bedside left me feeling unsure, and I had no pain until a month ago. For the past month I managed the pain with oil of oregano mostly, and ibuprofen occasionally.
    Things went nuclear last Sunday, with terrible uncontrollable pain about 8-9 on pain scale all night and rapid facial swelling early in the morning. Called my dentist, but she was not available to see me. Called an oral surgeon near me but they also don’t do emergencies. So called dentist back and she agreed I needed antibiotic. I am allergic to penicillin after getting an infection in a root canal in other tooth on lower jaw, other side, which is part of my uncertainty to get another root canal.
    I have decided to get the tooth extracted and my dentist already said she doesn’t feel she can get me numb, and recommends an oral surgeon, so I expect to go to an oral surgeon soon.
    My tooth still hurts about a 4-6 on pain scale, but the swelling in my face is nearly gone. There is still swelling in the tissues next to the tooth on the cheek side and a hard “module” that can be felt externally through my cheek.
    Would it be necessary to do another round of clindamycin starting tomorrow before proceeding with the extraction? Or, can a surgeon go ahead with it even if it’s not completely cleared up? And, is a second round of clindamycin preferred over a different antibiotic?
    My dentist hasn’t followed up with me and may be too busy to get to me, so I thought I’d see what you think. I’ve got the red-hair gene issues with numbing, extra sensitivity, early metabolizing etc. Thank you in advance for your thoughts!

    August 26, 2018 at 8:14 pm Reply
    1. RamseyAminDDS

      I have had many redheads with the same anesthesia gene!

      Basically in order to resolve the infection, the tooth needs to be removed. The tooth is the source of infection and should relieve everything once it is removed. No amount of antibiotics can cure a hot tooth that causes pain in the 8 to 9 scale.

      September 9, 2018 at 12:41 am Reply
      1. Kristi

        I finally got my situation resolved. It took seeing a total of 6 dental professionals and I had to go through a household move in the middle of it. The 4th dentist agreed to help me and she gave me as much numbing as it took to do partial endos on both teeth to get me out of pain and hold me over until I got to my new place. She also gave me a good recommendation of a dentist there. That dentist determined that both of my teeth were cracked, and the lower infection had still not cleared up after more antibiotics. She gave me a great recommendation for a local oral surgeon and he did the extractions 4 weeks ago. This week the pain from the infection is finally gone – I didn’t take any antibiotics with the extractions. The extractions went great, no bleeding at all after 30 min. No pain the next day either. Now I’m letting everything heal up and will be seeing my new dentist later this month.
        I did have to live with my hot tooth for 4 months, but getting connected to great professionals with good judgment gave me a good resolution. There is no substitute for experience! Thanks for your help!

        January 11, 2019 at 1:57 am Reply
        1. RamseyAminDDS

          awesome!! thanks for the follow up! 🙂

          January 11, 2019 at 2:55 am Reply
  21. Frances Simoni

    I have a tooth implant that is really hurting and antibiotics not working very well. My implant was put in 20 plus years ago. Will it calm and stay well in time with a different antibiotic..maybe??

    August 21, 2018 at 1:32 am Reply
    1. RamseyAminDDS
      August 22, 2018 at 11:30 pm Reply
  22. Lorraine Van Brunt

    I had two extractions on bottom right with immediate implants on June 13, 2018. I developed an infection with swollen face, gums, under tongue, and throat. I was put on Clyndomiacin for 5 days. There is still redness and some pain on gums around bridge behind implants, and some swelling under tongue. Today is July 4th. I’ve asked if another round of antibiotics will help and the dentist is hesitant. I was told antibiotics just mask the symptoms, they are waiting for one of the implants to “commit” so they can determine if one needs to be taken out. Wouldn’t 5 more days of antibiotics be a better plan? Thanks for your advice.

    July 4, 2018 at 3:57 pm Reply
    1. RamseyAminDDS

      I agree with you. And also if you are not allergic to penicillin I would suggest you switch to something else besides clindamycin.

      July 7, 2018 at 10:57 pm Reply
  23. Carolyn

    I have had three implants for about ten years with no problems. Recently, there has been an infection develop even through I practice good hygiene. Do I need to have a procedure done to clean out the infection or take low-dose antibiotics to clear up the infection. The pain waxes and wanes from being very painful to a low level of pain. Please advise by email.

    June 27, 2018 at 4:34 am Reply
  24. Chris

    Hi Dr. I had a periodontist do a bone graft behind #17 molar to correct a 10 mm pocket. The following day the flap began to turn necrotic then fell off. The doc said not to worry. 2 days later i had a horrible taste coming from the area and went back and he gave me a bottle of Peridex to put on the area and said to return in a week. My next visit I still had a foul taste but it had subsided some. I had research a little in between visits and heard of people getting antibiotics either before or after this procedure. I asked the doc why he didn’t put me on them and he response was “oh, I didn’t prescribe you antibiotics?” He the gave me a prescription for Augmentin 500 mg and said we will have to wait to see if the graft took. Meantime I have terrible sensitivity now that the root is exposed. What is usual protocol as far as antibiotics with this procedure?

    June 4, 2018 at 8:00 pm Reply
    1. RamseyAminDDS

      Is this a wisdom tooth? #17 in the American numbering system is a wisdom tooth unless you are making reference to the European system where this would be a second molar. If this was a wisdom tooth it seems strange to even try to save it with a 10 mm pocket. Under my care you would have antibiotics both before and after with this type of procedure but each practitioner has a different school of thought. Not all dental surgeries require antibiotics.

      June 6, 2018 at 11:01 pm Reply
      1. Chris

        I’m sorry it was second molar. Will that gum tissue ever grow back? Why do you think it died? Should i get a gum graft to cover the root or just leave it as is as long as the gum stays tight to the tooth? Thanks for your help. It takes a special person to make time like this for complete strangers.

        June 7, 2018 at 12:31 am Reply
        1. RamseyAminDDS

          That area is Sometimes inoperable. Surgical access is very difficult. Sometimes the area can be more successfully treated with a carbon dioxide laser first and then try to bone graft the root. Each situation is very different.

          June 7, 2018 at 12:49 am Reply
      2. Chris

        It has been about 3 months now since this graft. The area continually has a foul taste and odor almost chemical like. Small fragments still occasionally come out. The gum tissue that died never did come back but everything look pink and normal. I just can’t take the odor and taste coming from the area anymore. What are your thoughts or suspicions?

        August 13, 2018 at 1:50 am Reply
        1. RamseyAminDDS

          Unfortunately the graft likely did not take. It may need to be redone again. Be sure your dentist is truly an implant specialist for best results.

          August 16, 2018 at 5:16 am Reply
  25. Nancy

    I am having a tooth (#30) extracted and bone graft for an implant on Thursday, June 7, 2018. The tooth has an old crown that came off and the dentist determined there was new decay and the tooth was not salvageable for a new crown. The periodontist that will do the extraction and implant has prescribed antibiotics but did not mention when I should begin taking them. When do I start taking the antibiotics? Days before the extraction, after the extraction? The periodontist office is closed so I cannot contact him until Monday, June 4, 2018.

    June 2, 2018 at 2:15 pm Reply
    1. RamseyAminDDS

      One hour before is usually the best. But the dose one hour before is different (bigger) than the regular. You will need to call them. They should have alerted the pharmacy to write this down on the bottle.

      June 3, 2018 at 6:46 pm Reply
  26. Clermise Smith

    Hello, I had a root canal with a crown done on the 1st week of April. On April 16th I found out that I had an ear infection. I wad prescribed Amoxicillin. On April 25th I went to my dentist for toothache. Found that I have an tooth infection below the root. I was still on my Amoxicillin meds from the ear infection. My dentist could not understand why out was there since I was on my medication since the 16th. He removed my crown an put medication down the root. A calcium oxide horrible tasting liquid. There was no puss so he irrigated the tooth and put the crown back on. I was very sore and could not eat anything not even a soft fry. When I woke up the next morning my gum and face was swollen. What should I do? Did my ear infection cause my tooth infection or vis-a-versa? Help?

    April 26, 2018 at 2:58 pm Reply
    1. RamseyAminDDS

      This would be a better question for an endodontist… A specialist in root canals. I am a dental implant specialist. The only words of advice I can tell you is that it is possible to get an infection while you are on an antibiotic.

      April 27, 2018 at 1:58 am Reply
  27. Leah

    Hi!

    I recently had a bone graft on my lower jaw. It was the kind with the flap not the socket kind. Anyways, on day 8 I was still having pain and it was quite swollen. Went in to see my dentist and now I’m on clydimician and flagyl. For the first 7 days I was on amoxicilian. The swelling has gone down over the first 48 hours of these new antibiotics, but the oozing from the site has not ceased and I am still having some pain. Can infection post surgery be treated effectively with antibiotics? I’m worried that if the infection in the graft then an antibiotic isn’t going to affect it. Are my odds that this is going to cause the graft to fail and have to be removed?

    April 15, 2018 at 2:31 am Reply
    1. RamseyAminDDS

      It is too early to tell but not a good sign. They usually heal despite infection if the bone graft technique is correct and you are healthy.

      April 15, 2018 at 8:00 pm Reply
      1. Leah

        One thing I notice is that the suture along my inner gum didn’t fully close. Could this be why the infection was caused?

        April 15, 2018 at 9:10 pm Reply
        1. RamseyAminDDS

          not necessarily

          April 23, 2018 at 3:51 pm Reply
          1. Leah

            I’m three weeks post surgery and finished with my course of antibiotics. My pain is gone and there is no more discharge from the site, however my jaw still feels swollen. My oral surgeon told me this was the mass of the graft, but it feels like a previous infection I had from a failed apico. My face is slightly noticeabley swollen. Does this sound like it could still be infection?

            April 25, 2018 at 2:14 am
          2. RamseyAminDDS

            Give it a few more weeks. Some swelling takes one to 2 months to fully go away depending on your body’s response to inflammation and of course the type of procedure that was performed. Best of luck!

            April 27, 2018 at 1:34 am
    2. Dr. Awais Khan MDS MPH

      Why only amoxil. . . Why not amoxil along with metro/trinidazole… I hope your tooth would be fine now. . . But ask your doc if there are some meds that work better in a combo. And about your question about the origin of infection; your dentist can better answer it.

      May 10, 2018 at 7:42 am Reply
  28. Jennifer

    I had a (cadaver) bone graft on 3/27. Procedure went fine, and at first I only had pain that that I expected from dental surgery. Three days after surgery, I had horrible pain in the back of my jaw/gum line. It felt like it was from the Novocain needle poke. Had that same pain until I went back at the 2 week mark for stitch removal. At this point, I had been on 1 round of antibiotics pre and post surgery, then another round. At that appointment, she put me on a third round. Personally, I thought it was too soon for the stitches to come out bc the site looked like it was still healing. Anyhow, the stitches are out and almost a week later the incision site is in excruciating pain. There are late nights that I cry myself to sleep. I was put on Percocet and then Tylenol/codeine and they did nothing to stop the pain. I take anywhere from 3-4 ibuprofen, 3-4x per day. (Last night, I took 5!). As of yesterday, I’m also having pain near my ear and even up into my eye, and my jaw aches when I chew. Could my body be rejecting the implant? How can there possibly be an infection after being on antibiotics for 3 weeks? At this point, I wish I could reach in and pull the implant out on my own. By the way, I’m leaving for Florida in 2 weeks and there is no way I want to deal with this pain while on a family vacation.

    April 14, 2018 at 4:26 am Reply
    1. RamseyAminDDS

      hmmm….There may be remaining infected tissue in the extraction socket. You may want to consider removing the entire graft if it does not get better very soon. Something is not right here. A basic x-ray should be taken and possibly another 3-D scan. Let me know what happens

      April 23, 2018 at 3:47 am Reply
      1. Jennifer

        Turns out the gums were not healing correctly. When I looked in the mirror, I could see down into my gum line, the graft, and other things I did not want to see. I just called it a “flap” that was hanging there. Didn’t look like my gums were connected to anything! Doc said that I was basically walking around with an open wound. She put, what I call, liquid bandaid on it, then covered it with a gooey substance which she hardened/cured and made into a “papoose” that covered the open gums. Worked like a charm! Aside from having that wad of hard stuff in my mouth, I am just about pain free. The hope is that while my gums are covered and not being moved around and touched, that they will begin to heal.

        April 23, 2018 at 3:44 pm Reply
  29. Michelle

    Dr,
    I had a sinus lift January 12, with 3 implants to my upper right teeth. That Thursday I went in to horrible pain and was told it was healing and I might be just slow to heal. I was taking Cipro.
    On Monday I couldn’t take it anymore and went it for severe pain. He said my gum was swollen and gave me augmenton 875mg tid. He said he didn’t know why I was hurting so bad. That night I had the worst pain of my lift and about 2 in the morning my gum busted open and thick green pus was pouring out. About 1/4 cup if I were to measure. I called the next morning and he said just keep taking my augmenton and he’ll see me Wednesday. I went in Wednesday and he said keep taking my augmenton and he’ll see me Friday.
    He didn’t want to do any scans at this point. He said in 22years he’s never had a graft fail. I also have a wierd air feeling in my gums when I sniff, but he wasn’t concerned. So I go in Friday and it’s the same story! I’m still hurting, I’m still draining but come back Monday. I go in Monday and he (the oral surgeon)was running late so his partner saw me. He added flagyl and they said they’d see me Wednesday. I go Wednesday and I’m still having pain but the swelling is going down some. I’m still having pus and bone fragments. He said I’ll see you in a week.
    So here I am the last day of flagyl and I’m still having pus and bone fragments. The pain is definitely less and it’s still a little swollen and definitely numb. The drainage is still green with a foul taste. My appointment is Wednesday so3 days away. I’m at a loss! This has been the worst experience of my life. 3 antibiotics and more than 50 Motrin 800’s plus Tylenol round the clock every 4 hours. He doesn’t want to go back in and says the antibiotic can heal it even if the lift is bad.
    I need another professional opinion:(
    I’m also severely nauseous from the flagyl. But I’ve taken it tid as prescribed.
    Thank you so very much!

    February 4, 2018 at 2:14 pm Reply
    1. RamseyAminDDS

      Yikes…3d scan to Make sure drainage hole for sinus is open, decongestants to open of passages, **REMOVE GRAFT** because it has been too long and antibiotics to not get rid of the dead stuff and pus, culture pus. Augmentin and Flagyl is a great combo. Ask for zofran for nausea.

      KEEP ME POSTED –not normal!!!!!

      February 5, 2018 at 5:59 am Reply
      1. Michelle

        I went in today and it’s going to get cleaned and drained on Wednesday. He said he’d know when he goes in if it’s the membrane or graft. Thank you for your advice!
        This has been a long and exhausting 3 1/2 weeks!

        February 5, 2018 at 9:35 pm Reply
    2. RamseyAminDDS

      Yikes…3d scan to Make sure drainage hole for sinus is open, decongestants to open of passages, **REMOVE GRAFT** because it has been too long and antibiotics to not get rid of the dead stuff and pus, culture pus. Augmentin and Flagyl is a great combo. Ask for zofran for nausea.

      KEEP ME POSTED –not normal!

      February 5, 2018 at 5:59 am Reply
      1. Michelle

        Update: I went in yesterday prepared for the surgeon to clean it out. The ct showed my right sinus was full, he said my gum looked better than 2 days ago and I didn’t have any pus so he wanted to give me round 4 of antibiotics and see me in 2 days. Well I woke up with green pus coming from my gums and pain once again. I was told that the antibiotic can heal the membrane if it’s infected. But I’m 4 weeks in now and my stomach is a mess from all these antibiotics and with continued draining I’m at a loss!
        Do I demand he go in even after my gums supposedly look better? But continue to pus?
        I’m at my breaking point!

        February 8, 2018 at 2:42 pm Reply
        1. RamseyAminDDS

          Use probiotic florastor to help stomach.
          Graft needs to come out.
          Scan done?

          February 8, 2018 at 2:50 pm Reply
        2. RamseyAminDDS

          Sorry you said scan was done already.

          February 8, 2018 at 2:50 pm Reply
          1. Michelle

            Thank you for all your advice! I agree and have a call in for the surgeon.
            I’ll keep you updated.
            Again, thank you for all that you do!

            February 8, 2018 at 3:36 pm
          2. Michelle

            He’s going to go back in today! My only concern is the pus and pain is intermittent and this morning I didn’t have pus. It still feels like a big knot in my cheek and gum area and I took alieve so I’m not in pain.
            This happened Wednesday and that’s why he wants to keep waiting.
            Should regardless have him go in?
            Thank you again!
            Making decisions are stressful and confusing since I don’t know what’s going on.

            February 9, 2018 at 12:35 pm
          3. Michelle

            I went in Friday and he finally opened it up. First, I was awake with nitrous and when he numbed me in the sinus area I felt and tasted all the pus and medicine drain down my throat in a rush. It was a very painful and stressful experience.
            He cleaned it out and said the membrane was bad and desolving and part of the graft didn’t look good either so he only took out the bad part then cleaned everything. I was put back on augmenton 875 bid. And since I don’t tolererate Sudafed told to take dimeatapp. I really hope this will be the answer for me to heal.
            I’m extremely sore and achey from the procedure today but I will say the green drainage that I was getting from my mouth and nose is gone at this time.
            I’m nervous because he didn’t take the entire graft out.
            I don’t want to ever have this traumatic experience again.

            February 11, 2018 at 1:46 pm
          4. RamseyAminDDS

            This is definitely not a usual experience for most. Of course complications can happen but we try to avoid them at all costs. Seeing a very experienced provider will prevent or reduce the chance of complications. Just so you know, I have re-grafted patients that have had failed bone grafts in the past with great success. It is possible if you ever get the courage to do it again.

            thank you so much for sharing your entire story from beginning to end

            February 14, 2018 at 10:58 pm
  30. kj henderson

    wish I could have heard your information, but sound of your voice was so soft I could not hear you. No way to turn up the volume

    January 10, 2018 at 5:27 am Reply
    1. RamseyAminDDS

      I just had my website people check it and I listened to it myself and volume is just fine!

      January 10, 2018 at 7:10 pm Reply
  31. Erica

    Hello I hope it’s ok to leave this message here but I have recently had my bottom left 2nd molar from back retreated with root canal. The tooth itself is no longer sensitive like it was by I am still having some jaw ache and pressure type feeling and my gums feel very irritated but look fine. I also get sharp pain from ear down the side of jaw. My Endodontics said the next step would be extraction my fear is I am allergic to many antibiotics penicillin, azythromyacin, keflex and clindamycin which are all the preferred antibiotics for implant. If I go with a bridge to avoid antibiotics does this put my jaw or teeth at greater risk of anything?

    December 30, 2017 at 7:34 am Reply
    1. RamseyAminDDS

      not likely……If I go with a bridge to avoid antibiotics does this put my jaw or teeth at greater risk of anything?

      December 31, 2017 at 3:53 am Reply
  32. Joy

    Dear Dr.
    I want to have extractions, cleaning, sinus lift, implants 8-10, and veneers in the Dominican Republic. It will take a team of 5 doctors to do the work right. I have to stay 2 weeks. Do you think it’s safe to do all this in two weeks?

    December 30, 2017 at 5:10 am Reply
    1. RamseyAminDDS

      Who will handle your complications when you return?

      January 29, 2018 at 1:58 am Reply
  33. Rick Erickson

    My wife has a root canal over 50 years ago. She had a root canal redo in ~1995 after a apical resection did not eliminate an infected root canal. Amazingly the infection subsided. Over a month ago she develop a mild pain in the upper gum with swelling in the apical area and was placed on antibiotics for three weeks while we were on vacation. She followed up with her endodontist who noted a pustule on the upper gum, opened it up, purulent material drained, and he noted a cracked root. Antibiotics were continued and she was sent to an implant specialist. His xrays demonstrated that the apical area was the only infected area. He is planning on extracting the tooth and inserting an implant on the same day. Would it be preferable to extract the tooth and let the area rest for a few months before inserting the implant? I am concerned that the infection could spread to a congenital heart valve abnormality. Thanks

    August 3, 2017 at 3:53 pm Reply
    1. RamseyAminDDS

      Thanks for your detailed explanation!!!
      Immediate implants by a skilled provider are very predictable. Of course a two stage procedure is completely ok but if the long term success is the same for both methods, then the choice becomes more obvious. If this is a front tooth it can make it more predictable or more risky. Just have a frank discussion with your dentist about it and ask about their past experiences in similar situations.

      Antibiotics should be on board before the extraction to prevent issues. If the infection has active pus, pain and redness I would not place the implant.

      The rules are different for one implant between natural teeth vs when I remove all teeth and place 12 implants simultaneously.

      Good luck. 🙂

      August 5, 2017 at 8:42 pm Reply
  34. Lina

    Hi Doctor Ramsey, Thank you for your post and video.
    Acute question: I just had a dental implant procedure done at a specialist clinic, not my normal dentist. I was given antibiotics to take post surgery (which is right now now): Amoxicillin for 7 days (no pre-antibiotics). I was not prepared for this and I don’t want to take Antibiotics..

    Im 30 and very healthy. No smoking or drinking, Taking lots of vitamin C and supplements.

    Do you think it’s a stupid risk to run not taking the antibiotics? I’ve read several studies online and see that succes rate without A is 94% vs, 97% with A. In healthy, low-risk people like me.

    Thank you, your opinion is very muc appreciated and I will read your other comments now.

    February 6, 2017 at 8:16 pm Reply
    1. RamseyAminDDS

      An implant is a foreign body that “in general” should be covered by antibiotics. Many of these studies are done with really simple, straightforward dental implants and not ones that are in bone loss situations or bone grafted situations. If it were me I would take the antibiotics and I would also take a yeast based probiotic along with. This way it does not cancel out the probiotic because it is a nonbacterial version. I like the brand floarstor and recommended routinely. I would also suggest to her mouth rinsing with 0.12% chlorhexidine 3 times daily for a week. This has antibiotic properties also. Without antibiotics, most of the surgical procedures done in medicine today would not even be possible!

      The providers experience, surgical sterility and time taken can also increase or decrease your chance of becoming infected

      February 8, 2017 at 8:14 pm Reply
      1. D

        Can the antibiotics be taken shorter than the 7 day traditional recommendation if no signs of infection/problems are present? I have read that there are a lot of conflicting or lack or research supporting the full duration of the antibiotic.

        August 30, 2017 at 5:44 pm Reply
        1. RamseyAminDDS

          antibiotics should be used very judiciously. But there are times where a shorter duration is fine and there are times where I will place a patient on an antibiotic for 2 solid weeks. This is not a decision that should be made by you but rather evaluated by your physician/dentist based on so many factors such as difficulty of surgery, surgical flap size, vascularity, medical comorbidities, bone density, medications, age, introduction of foreign bodies, bone graft dental implants etc. If you develop an infection will having any sort of advanced procedure your likely to lose the implant/graft etc.

          August 30, 2017 at 9:58 pm Reply
  35. Jo Kucher

    Dear Doctor, I had a tooth extracted, due to a cracked root canal and an immediate bone graft placed with an implant screw. The site was healing very nicely at week one, then it started to have a foul smell and part of the bone graft seemed to come out. Since then at week 3 I have a very swollen gum, it has swollen over the implant and I can no longer see the top of the implant. Also I now have pus draining from the site. I started on Azithromycin 500 mg. and am on day two of the antibiotic. I have also been doing salt water mouth wash. There is redness and pain in the area now. What should I do, I have travelled and am not in the same country as the implant was performed. Should I seek a local dentist? How long should I wait until I see someone?

    December 26, 2016 at 9:35 pm Reply
    1. RamseyAminDDS

      Do not wait to see a dentist. The area should be evaluated and a second antibiotic or different antibiotics should be used in addition to a possible Betadine irrigation or debridement. There is a good chance your losing bone or could lose the implant entirely. Find someone that focuses on implant dentistry rather than just regular dentistry.

      January 11, 2017 at 8:53 pm Reply
  36. Alison

    I think this is the most informative site about dental implants.
    I want to say thank you. There are just not enough honest open sites like this.
    I think there is a lot of people out there who have not been given the facts needed to make an informed choice.
    I wish I had found this before my surgery.

    November 25, 2016 at 9:19 am Reply
    1. RamseyAminDDS

      Thank you 🙂

      November 26, 2016 at 6:06 am Reply
  37. Vee

    Hi
    Dear Doc
    I had a root canal done 4 weeks ago..(bottom right) it caused terrible pain, also crown was too high,it has now been adjusted. It hurt for a full 7 days! While healing i noticed i had another pain i thought it was the top (upper right) of the teeth but the dentist said nothing was there, there was no crack! . But i just realized it was the tooth behind the root canal root.. it feels sensitive to biting!! I cant believe this is happening!! Its been so expensive! Is it possible that the tooth behind (root canal tooth) become infected? Does this happen ? Cant this be cleared by antibiotics… This tooth was fine before the one in front became infected! Just what do i do now? I cant afford any more time from work or money! Wont this just get better on its own?

    September 13, 2016 at 2:59 pm Reply
    1. RamseyAminDDS

      Yes. This can happen.
      This blog is intended for dental implant related questions though. I try to keep it on focus.

      September 16, 2016 at 4:02 am Reply
  38. Purnima

    Dr. Amin,
    Thank you for your informative video. I have to do an extraction of tooth #3 this coming week because it is still infected after a root canal re-treat. The additional complicating factor is that I also need to have endoscopic sinus surgery for polyps and chronic sinusitis – this was originally scheduled for 2 weeks from tomorrow but now may need to be rescheduled. My sinus dips down right above the root of this tooth, so it might likely require a sinus lift procedure too.

    My question is on timing of the bone graft – whether it needs to be done at the time of extraction, or can be delayed a couple months. My periodontist said he always ideally likes to graft bone at the time of extraction if the plan is to do an implant for the missing tooth, which I want to do. This would mean delaying my sinus surgery, which could be done, but how long do you think I should wait before the sinus surgery if grafting is done? And what would be the disadvantages of waiting a couple months to do a bone graft?

    Also, if there is a pre-existing severe infection around the root of this tooth, does this make bone grafting at the time of extraction more risky? Thank you.

    September 7, 2016 at 4:47 pm Reply
    1. RamseyAminDDS

      The two procedures should be separated by a 2-3 months.
      I would take out the tooth first and graft at the same time as long as the infection hasn’t penetrated your sinus.

      This way if you have any sinus complications the ENT can help on the tail end.

      September 8, 2016 at 3:43 am Reply
  39. Dear Doc Amin,

    Good day, im 28yrs old from philippines. i am so worried of my bone graft and don’t know what would be the consequences. I had 2 implant and bone graft at the same time 1week ago on my upper front tooth. After 1 week i have to come back as the stitch on the other one was gone loose and the bone graft was exposed i can tatse the grafts so i came back to him and he stitch again. The graft still expose and 1 day later when i woke up today the bone graft that has been exposed became a whole now that makes me worried. The other one was all ok which he made extraction too. But this one here that makes all the complications was a missing tooth 11yrs ago. What can u advice me doc, i am so worried please help.

    Thanks

    Kind regards,
    Erma

    June 30, 2016 at 5:01 am Reply
    1. RamseyAminDDS

      I think I already answered this question before

      July 4, 2016 at 3:28 am Reply
  40. Tim Smith

    After, I had a infected tooth extracted and my face swelled up. I had to submitted to the hospital due, to swelling.

    June 23, 2016 at 4:24 am Reply
    1. RamseyAminDDS

      I’m guessing this was a lower tooth like it wisdom tooth or second molar that can compromise your ability to breathe if the infection heads towards your throat or if you develop hematoma on the inside surface after extraction.

      June 26, 2016 at 6:08 pm Reply
  41. Lori

    I hope you can answer I am having an implant 6/17 no bone grafting planned…although this guy seems to prescribe antibiotics for implants regardless. I am dead set on not taking them unless infection occurs however i do have some holistic options on board for preventative. As I have no known health issues and am a clean unprocessed diet would this be an option you would entertain? I don’t really like what happens to me on antibiotics and it takes months for me to get my body back to normal after a round of them.

    June 12, 2016 at 6:52 pm Reply
    1. RamseyAminDDS

      There are more factors to decide this than I can answer in a single post.

      If the implant is really basic I would suggest at the minimum a single loading dose of antibiotics 1 hour prior to first incision. An implant is a foreign body entering the bone. The bone space connects to many non intra oral spaces that infections can spread.

      Just some food for thought. ?

      June 12, 2016 at 9:41 pm Reply
  42. Diane

    Dear Dr. Amin,

    At this time I’m hoping you will be able to give me your opinion in regards to my current situation.
    I had an implant placed last July after the tooth was pulled 5 months prior.
    I had no infection after the implant was placed. About 2 months ago the screw in crown was placed . When the crown was placed the area were it was inserted was very sensitive for almost a week.
    Because it was sensitive I made the mistake of not cleaning it for the first week. I then started having symptoms of infection. It was on a Saturday when I noticed the infection. Because the implant was placed in the area of my left nostril, I decided to pour warm salt water down my nose to hopefully get rid of the infection. When I did pour it the pain was extreme as if someone hit me in the face with a baseball bat. I immediately took some advil and kept rinsing my mouth with salt water for a few days. The dentist then put me on anti-biotics and the infection cleared up. A few weeks later I fell asleep after attending a dinner party without cleaning my teeth. I woke up with another infection and started to again rinse with warm salt water and Listerine. A few days later I went to my regular dentist to have her unscrew the implant crown to check for infection and she said there was nothing visible. After another round of anti-bio tics and rinsing after every meal, I have no more issues and it’s been almost a month now.

    The x-ray that my regular dentist took, according to her, showed a slightly dark and cloudy area around the new implant tooth. She emailed it to me as well as to the implant doctor. He then had me come in to check the implant via his own x-ray. He has told me that because I have no current symptoms of any infection and that the implant and crown are not wiggling or lose, that there seems to be no issue currently. He does want me to come back in a month so he can take another x-ray and has said he will take out the implant if I have symptoms that there is an infection.

    Here is my question which I would so much appreciate if you would answer—

    Does an x-ray that shows some a slight dark and cloudy area definitely mean the implant is infected and needs to be removed even when there are no symptoms of failure?

    It’s the implant on the right side that is the one in question. I’m not an expert but I don’t see any difference at all around the area of either implant.

    Thanks in advance for any info you are willing to share with me.
    PS—I have 2 digital x-rays but don’t know how to post them here. Is there a way I’m able to post the x-rays?

    Thanks for your help!
    Diane

    April 23, 2016 at 11:55 am Reply
    1. RamseyAminDDS

      This post on peri-implantitis may help.

      This *Might* be the problem.

      April 27, 2016 at 8:21 pm Reply
  43. Hi … I have read through the blog and watched your video. I had an extraction and bone graft tooth #3 on 4/19/ 2016 after having a failed root canal and apico. The tooth showed signs of localized infection. I have a history of sever c diff and can’t take ANY antibiotics according to my GI. The extraction went well not much pain and day 2 zero pain however, your comments are concerning about the risk of infection . My oral surgeon said he cleaned the infection very well and all looked great and he understood I can’t take the antibiotics. Is there still a high risk of infection and how long until I am out of the woods?
    Thanks,
    Chip

    April 20, 2016 at 2:30 pm Reply
    1. RamseyAminDDS

      All you can really do is assume the risk at this point. Either way is risky whether or not you take antibiotics or you don’t. The size and technique of the graft also placed a big role on whether or not it becomes infected or not. Because you developed C. difficile before your likely to develop that again. As long as you have a good immune system, you don’t have any bad lifestyle habits and the graft is fairly small hopefully nature will just do its thing. Good luck!

      April 20, 2016 at 11:40 pm Reply
      1. Chip

        Thanks for your reply! After having 4 severe cases of c diff that lasted for over a year and ended needing a FMT to cure the c diff obviously infection concerns me. What is the general time frame one would be looking at if an infection was going to occur?
        Thanks!

        April 22, 2016 at 3:43 pm Reply
        1. RamseyAminDDS

          The first month after having the implant surgery and/or bone graft would be the most common to develop an infection. Did the FMT Fecal Microbiota Transplantation work?

          April 27, 2016 at 8:45 pm Reply
  44. Jennifer

    These videos are great. I had an upper molar extracted in November ’15 and have been putting off the implant process, even debating whether or not to replace it (the second from the back is what’s missing). The tooth originally had a crack under a crown and they attempted a root canal but it had to come out. I was on one course of climomycin (sp), then another on cipro back to back for the extraction. I developed C-Diff as a result. I’m only 55 and haven’t been near a hospital in 8 years and hadn’t been sick literally for 25 years prior to the tooth incident. I’ve recovered from that, but now I’m terrified not of getting an implant, but of having to take antibiotics. My dentist says there is no alternative. That’s why I’ve been considering leaving it alone. Have you heard of such a scenario? He doesn’t think I’ll need a bone graft – just the “tapping” procedure that you described. Thank you!

    April 16, 2016 at 5:50 pm Reply
    1. RamseyAminDDS

      Each situation and each patient’s history has to be evaluated carefully to make a decision to do a dental implant without any antibiotics at all including preoperative antibiotics. Regardless, you’re taking risk but you need to have this discussion with your dentist. You might want to see somebody who is very experienced and has a long track record of success to reduce your chance of infection if no systemic antibiotics will be used.

      Antibiotics are most important when bone grafts are involved.

      April 21, 2016 at 12:00 am Reply
  45. Marcy

    I was wondering if you have seen a situation where Clindamycin caused an increase in E. Faecalis? This happened and I was put on Doxy and Flagyl and they didn’t help.. my symptoms worsened and then I was put on Cipro and I feel as if I may get pancreatitis.

    April 11, 2016 at 1:33 am Reply
    1. RamseyAminDDS

      you should see an infectious disease specialist and be tested for susceptibility and sensitivity for antibiotics

      April 21, 2016 at 12:28 am Reply
      1. Marcia

        Thank you.. How do they do the testing ?

        June 12, 2016 at 10:16 pm Reply
        1. RamseyAminDDS

          This is what infectious disease specialists do for a living

          June 13, 2016 at 11:42 pm Reply
  46. Helen

    I have diabetes. I was told I need antibiotics for tooth removal and possibly implants. Issue here is I have had awful side effects on these. It’s bad enough to need all this work done but even worse is the thought of medication. Antibiotics cause my nervous system to go crazy causing effects like body burning, anxiety and so much more. Are they really needed. And if so what could be a conservative plan? I appreciate your video. Thanks.

    March 15, 2016 at 1:01 pm Reply
    1. RamseyAminDDS

      each situation is unique. Her diabetes status needs to be evaluated in the context of the surgery and surgical technique/materials that will be used. You should speak to your dentist about this. Diabetics are much more prone to infection and slower healing of bone grafting and dental implants. The lower your blood sugar and hemoglobin A1c, the better

      March 20, 2016 at 11:28 pm Reply
  47. Phyllis

    Good Morning Doctor-

    I had bone grafting and 3 teeth implants done in Jan 22nd 2016… It is today Feb 22nd of 2016.. I have been on more medications and antibiotics, and I’m still in the same situation….. .. The middle implant got all infected, my Surgeon cleaned it all out and put me back on Biaxin for 10 days.. I’m going back this evening to see him, my Chin and bottom lip are all num… its already 5 weeks..

    Please reach out to me phyllism@bachrachgroup.com,

    February 22, 2016 at 3:54 pm Reply
    1. RamseyAminDDS

      If there is questions as towards whether the implants are causing the numbness they should be taken out. This will likely resolve the infection and allow areas to heal.

      I would also suggest a treatment with some steroids also. Keep us posted

      February 27, 2016 at 6:22 pm Reply
  48. Jessica

    Hi Dr, Amin,

    Tomorrow my root canaled tooth #14 will be extracted. I am not prescribed antibiotics prior to my extraction which I am happy about it. My gum around tooth #14 is not swollen or sore. I feel fine. This is probably a dumb question but since I am very nervous about my extraction, will I feel pain during the extraction? I heard local injection will not numb my infection side if I don’t use antibiotics and having an infected root canal before the extraction date…

    My other question is I will have bone grafting right after the extraction. And then plan is having an implant in 4 months. I don’t like to use antibiotics especially because I used a lot of antibiotics in the past and I am only 30 years old.I would rather use vitamins and supplements to fight with the infection. But of course I do not now if it is required for my future implant operation. Do you suggest using antibiotics after bone grafting?

    February 1, 2016 at 12:36 am Reply
    1. RamseyAminDDS

      How did it go? Yes antibiotic should be used after bone grafting. Chance for infection substantial.

      February 2, 2016 at 6:01 am Reply
      1. Jessica

        Thank you Dr, Amin. Your articles made me somewhat knowledgeable and my doctor was suprised while I was asking him some questions before my extraction:) hopefully I did not bother him.
        I did not feel anything during the extraction. It actually happened pretty fast. I hope that area is cleaned very well… Extraction With the bone grafting took about 15-25 minutes of the nitrous didn’t fool me:)
        I was not given antibiotics prior. My dentist said that the only reason he is giving me antibiotics now is because bone grafting. It is called cephalexing. As for pain relievers I am using Vicodin and ibuprofen one at a time exchanging. I took a day of from work and will take today real easy. Hope my healing goes well without any contradiction.

        February 2, 2016 at 1:26 pm Reply
  49. Dan

    Hello Doctor,
    I had a block bone graft done a month ago and everything was going well until I noticed the gum above one of the teeth near where the graft was placed has now healed and also noticed small amount of pus coming out. I did not take any antibiotics after the surgery and the surgeon not placed me on it for a week. I do not have any pain unless I press heavily with my finger on the gum where the graft was placed. Should I avoid the area with my tongue completely or is it a good idea to massage it around the healthy area that has healed. I was told I can use the antibiotic mouthwash and my finger to massage the area around. Thank you very much.

    January 14, 2016 at 5:42 am Reply
  50. Dan

    Hello Doctor,
    I had a block bone graft done a month ago and everything was going well until I noticed the gum above one of the teeth near where the graft was placed has not healed and also noticed small amount of pus coming out. I did not take any antibiotics after the surgery and the surgeon not placed me on it for a week. I do not have any pain unless I press heavily with my finger on the gum where the graft was placed. Should I avoid the area with my tongue completely or is it a good idea to massage it around the healthy area that has healed. I was told I can use the antibiotic mouthwash and my finger to massage the area around. Thank you very much.

    January 14, 2016 at 5:40 am Reply
    1. RamseyAminDDS

      WHAT!!! DO NOT rub the area!! this is one of the worst possible things you can do!!! Are you absolutely certain it was an onlay block bone graft? This is a procedure that definitely requires oral antibiotics. Perhaps you did not realize that they prescribed you an antibiotic? I would call the office ASAP and see your surgeon. I perform a block graft quite routinely. Here is an article about it.

      January 14, 2016 at 9:41 pm Reply
  51. Karlene vanfleet

    My son has infection smell in his mouth where the bone graft is, he loose teeth, it’s oozing and serious pain. The dentist is hard to get ahold of and we have a poor insurance. He is taking hydro for pain and penicillin for antibiotic. Now what? Surgery was 7 days ago.

    December 17, 2015 at 10:24 am Reply
    1. RamseyAminDDS

      He needs to see the surgeon for a follow up asap….please reply when you find out the outcome for the benefit of other readers.

      December 19, 2015 at 8:17 pm Reply
  52. Vickie

    I just had a dental implant done and it is infected. My dentist increased my Clindamycin to 300mg 4x per day. I’ve finally had some relief, but still am having pain. I have about 3 days left on my antibiotic….. How long does this type of infection take to clear up!! Thank you for a reply in advance!!

    December 12, 2015 at 3:32 pm Reply
    1. RamseyAminDDS

      Some infections can be aggressive and take 1-2 weeks to cure. I would suggest a culture and sensitivity test and perhaps switching antibiotics or adding a different antibiotic to the mix. Is the infection gone now as of Christmas Day?

      December 26, 2015 at 6:19 am Reply
      1. Victoria

        We switched to Augmentin about 3 days ago. They took the bone graft out on Monday. I’m feeling a lot better, but still a little swollen and slight pain. I’ve been able to just use 800mg Motrin. I think I’m on the mend. Thank you for your reply.

        December 26, 2015 at 8:52 pm Reply
        1. RamseyAminDDS

          wow…. Took the graft out….. I rarely have to do that and I do bone grafting procedures every single day.

          I’m glad you’re better but I am only sorry that you’ll end up having to repeat the procedure. There are other options of antibiotics and local treatment rather than removing the entire graft but sometimes it is the only option. Of course without seeing you there is no way that I could be certain.

          Thanks for the follow-up

          December 29, 2015 at 2:37 am Reply
  53. James Jackson

    a month ago, firstly my doctor took a 3D scan of my mouth areas that I had been considering having dental implant, then he did a virtual surgery on the computer without touching my mouth. It didn’t hurt at all.

    November 21, 2015 at 9:16 am Reply
    1. RamseyAminDDS

      Great! Here is some info to help! Virtual surgery is extremely important

      November 26, 2015 at 7:03 pm Reply
  54. Ng Hao

    I just had a dental implant and was given antiobiotics Metronizadole and swelling medicine Dasathasone. I took one of each immediately after the surgery. Is it compulsory for me to continue taking the medicine as i am trying for a baby with my wife and i was told by my urologist that it is not good if the baby is conceived while i am on such medication? Will infections occur if i do not take them? After a night of rest, i do not feel any pain around the implant area. Thanks.

    November 19, 2015 at 10:33 pm Reply
    1. RamseyAminDDS

      Hi Ng,

      You’re taking additional risks by not being on the antibiotics and the dexamethasone if it was prescribed by your implant surgeon. If it was a very straight forward, non-complicated dental implant without a bone graft and you’re a healthy young man with a healthy lifestyle, you will likely be okay.

      The experience of your dentist is got a lot to do with how well things will turn out. Also using a sterile set up like I have shown on this post, will help decrease the chance of infection. I’m sure you will be fine. Good luck on the baby….. I have a few kids myself and they are great!
      😉

      Happy Thanksgiving

      Very respectfully,

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

      November 26, 2015 at 7:11 pm Reply
  55. Narcie Haran

    Dr. Amin: I watched your video and have a few questions. I am post surgery from 9/18/15 and still having pain and swelling in the left lower jaw. I had two implants placed, teeth 20 and 21 and am beside myself. For two weeks I have been taking 800 mg of Ibuprofen and Hydrocodone for pain.

    I did go to a well known dental school in Philadelphia to have this work done but I am really tired of being in pain. I did go back a few days after surgery because I was in so much pain and the student dentist said everything looked good, no infection.

    I had the stitches out last Friday, October 2nd and again he said everything was healing nicely. If everything is healing nicely why do I have so much pain and swelling still. If I knew it was this much pain I would not have had this done and would have opted for a partial plate.

    Thank you for any input.

    October 7, 2015 at 11:26 am Reply
    1. RamseyAminDDS

      Take a 3d scan to evaluate the position of the implants to the nerve. It is possible that it is pressing on the nerve.

      Also a scan and a regular X-ray can look for rare things such as osteomyelitis.

      I am sorry you are having so much pain…this is not common but can occur especially in the lower jaw.

      If pain is not gone in 4 weeks and it is that bad, you may want to remove the implants.

      Your past and current medical history may also be the cause of the pain.

      October 12, 2015 at 10:27 pm Reply
  56. Steph

    Hi there,

    I’m wondering if you can offer some advice? I had my back upper 3rd molar extracted approximately 7 weeks ago. It was done with stitches and a cheek flap. Since this time I have suffered from continual pain in the bone in and around the extraction site. I think it’s improving and then it starts getting worse again.

    I have also had sinus surgery recently due to a bacterial infection caused by perforation of the same tooth. My sinus issues still continue and I’m on 2 antibiotics and halfway through a course of pulmicort which I’m inserting into my sinus rinses. I’m doing salt water rinses and basic pain killers only take the edge of the pain.

    I’m at my wits end and I feel as though I’m annoying my oral surgeon as he cannot see anything wrong and xrays have shown no abnormalities. I’m 33 and have been on antibiotics for the most part of this year and am desperately unhappy. I’m wondering if you can offer any advice or suggest any avenues that have not been explored.

    July 23, 2015 at 10:01 pm Reply
    1. RamseyAminDDS

      Hmm…I hope you have had a ct scan and that the surgeon and the sinus doctor are the same person or they know what the other is doing. If not, see an ENT immediately.
      If you smoke or have any other medical conditions this could slow things down too.

      Some bone infections can get so bad that they turn into osteomyelitis and would require antibiotics via IV. Fortunately osteomyelitis is not that common in the upper though.
      The other likely thing is called an oral Antral fistula. This must be closed surgically for you to heal.
      Make sure if you reply to cut and paste this thread back into your new post.

      Good luck.

      July 24, 2015 at 3:46 am Reply
      1. Steph

        Hmm…I hope you have had a ct scan and that the surgeon and the sinus doctor are the same person or they know what the other is doing. If not, see an ENT immediately.
        If you smoke or have any other medical conditions this could slow things down too.

        Some bone infections can get so bad that they turn into osteomyelitis and would require antibiotics via IV. Fortunately osteomyelitis is not that common in the upper though.
        The other likely thing is called an oral Antral fistula. This must be closed surgically for you to heal.

        Hi there,

        Thank you for your reply. Unfortunately, I cannot seem to find a doctor who can help with both the tooth and the sinus. I have seen two ENT’s and had the tooth removed by a reputable oral surgeon. The CT scan revealed that there is some congestion remaining in my sinus, however, I don’t believe that there was any evidence of an oral fistula. Every time I go off antibiotics, the sinus issue seems to flare up and becomes refilled with pus. I cannot help but feel that the pain at my extraction site is related. Examination of the site shows that everything is healing as it should. It is possible for an oral fistula to remain undetected on a CT scan? The new ENT I am seeing seems to think that the problem may be nerve related, but I am skeptical as the pain is always there. Anyway, any additional insight would be much appreciated.

        Thank you for your response.

        July 24, 2015 at 10:14 am Reply
        1. Steph

          In reference to the above questions and information I have attached a link to a Dropbox folder with my CT images:

          https://www.dropbox.com/sh/v30qq0kldxmb6pd/AAAnsu15uOfmkp9QeKzn2ksia?dl=0

          Thanks again for your help.

          July 24, 2015 at 11:14 am Reply
          1. RamseyAminDDS

            if you’re interested in the virtual consult with me please call my office and speak directly to Sophia

            July 27, 2015 at 4:21 am
        2. RamseyAminDDS

          It is possible for an oral fistula to remain undetected on a CT scan? –YES

          July 27, 2015 at 4:21 am Reply
  57. Kristine

    My dental implant in #5 that also had bone grafting, shows bone loss in the latest x-ray. I was told, I cannot get the implant. He told me to come back in a month!
    I went to another dentist because he is giving me invisalign braces on my bottom teeth. He said the “bone loss” is an infection, and he prescribed me the Z-pack as we were going out of the country, and that area, had shooting pain.
    Why would he not make an appointment to have it removed again?
    It hurt like hell when he had to remove it the first time it failed.
    He only prescribed antibiotics when he drilled in the implant.
    No antibiotics during the first bone graft, or even the second one, when he had to SCRAPE out the infected graft.
    I have a headache now and also #12 has shooting pain.
    No x-ray to check even when I complained about it.

    Is this NORMAL behavior when things go bad?
    I am terrified, both implants HURT, and I am getting NO CALLS back from the dental surgeon, or my own dentist.
    I emailed PUBLIC HEALTH, because I cannot get anyone to help me.
    I do not want to sue anyone. I just want this mess addressed!!!!!
    What should I do now?

    June 19, 2015 at 2:34 pm Reply
    1. RamseyAminDDS

      you should probably see someone else.

      July 21, 2016 at 12:53 am Reply
  58. Th

    Thank you for this video. It has helped me immensely. I made an appt to see you in July.
    😉

    May 23, 2015 at 2:21 pm Reply
    1. RamseyAminDDS

      Wow. Thank you for your kind words. I look forward to meeting you personally.
      🙂
      Dr. Amin.

      May 23, 2015 at 11:13 pm Reply
    2. RamseyAminDDS

      I saw that you are on my schedule!!! See you soon!

      May 27, 2015 at 6:35 pm Reply
  59. Sunny L

    Is any there any estimated time to take Antibiotics after bone grafting?

    January 29, 2015 at 5:37 am Reply
    1. Ramsey Amin DDS

      7-10 days would be considered normal.

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

      January 29, 2015 at 6:16 am Reply

Write a Comment

Monica D.
Monica D.
December 29, 2020.
There aren't enough words (and I have a lot of words) to tell you how grateful I am to have found Dr. Ramsey Amin and his wonderful staff. I had an enormous amount of bone loss and I was hopeless after being treated by a different doctor for two years. I had multiple procedures such as gum graft, extractions, and a sinus lift. After all of that, the doctor released me and told me he could not help me any longer. He sent me to a large teaching hospital - who also had no idea how to help me. I was terrified and embarrassed. I had been missing teeth due to those procedures since 2017. That sent me out on a journey of meeting with no less than five different dentist/oral surgeons. Most of them shamed me for the bone loss and wondered what I had done to cause this. In reality, I had done nothing. The bone loss is my body's immune system fighting me, as well as hereditary traits. In fact not only was I having difficulty being able to have implants, I also had so much bone loss that I was also not a candidate for dentures. I researched "what to do when you have bone loss and can't get implants" and I found Dr. Amin's website. Then I researched him, read his reviews, watched every one of his You Tube videos. I called and got an appointment, and kept going to consultations with other providers. I had long since stopped smiling and being social. Missing teeth and the shaming was affecting my life so adversely. When I met with Dr. Amin for my consultation he was ready. He had all of my records and had already reviewed my scans. But more than that, he genuinely wanted to get to know about my life. He was/is authentic, kind and extremely professional with so much success and experience in difficult cases like mine. He worked up a treatment plan & I came back two weeks later to discuss my options...and the journey began. I have had three procedures under IV sedation, no pain, no narcotics needed for aftercare. Dr. Amin is a consumate, experienced oral surgeon who cares about your health & understands your fears. He communicates every step of the way and will provide you with all the information you need to make a decision to improve your health. I am still working toward my end goal, and we had to zig from traditional implants and zag to zygomatic implants instead...which is the reason I chose him in the first place. If there was nothing else that could be done to get me healthy & smiling again, I knew he would have that option to help me. And of course 2020, the year of CV-19. Don't worry, Dr. Amin & his staff follow all health & safety protocols. This review is long, because it is important you know my journey, so you might understand how fortunate I feel to be healing. I'm torn, because this place is like a great restaurant, I want to shout from the rooftops how great it is, how great he is. And at the same time, I want to keep this all to myself. I come 75 miles each way to see him. I know people travel from all over the world for his expertise. Do yourself a favor, have a consultation. You won't regret it. Dr. Amin is amazing and so is his staff.
Jennifer B.
Jennifer B.
December 18, 2020.
I cannot speak highly enough of Dr. Amin and his professional staff. I have to start off and say that I am absolutely TERRIFIED of the dentist due to several past experiences. I found myself putting this off for YEARS until I was referred over to Dr. Amin. I was petrified on my first visit... but he along with his WONDERFUL staff made me feel so calm and at ease. I had quite a bit of work that needed to be done, but we found the perfect plan that worked out for me, and I couldn't be happier. Words cannot express my gratitude to each and every staff member that made me feel safe and comfortable. Dr. Amin was always so attentive in asking if I was ever in pain... and I never was. These are truly remarkable individuals, and I'm so lucky to have a dentist that I can trust. I ABSOLUTELY LOVE each and every one of you! Thank you,
D M.
D M.
December 17, 2020.
I cannot say enough positive things about Dr. Amin and his staff. I originally found them on Yelp about two years ago. I needed an implant, front tooth of all places, and was extremely nervous not only about surgery but about how it would turn out. Let me just say I just adore the staff. Everyone is crazy friendly and the whole office has a very positive vibe. The staff is adorable and always has me smiling by the time I leave. They are all thorough and on-point about what they do, and I truly appreciate it. They are quick to respond to my emails no matter the question, and their appointment reminders are great too. Dr. Amin is very thorough and reassuring, and answered any questions my husband or I had. My regular dentist had questions about the procedure and Dr. Amin's office even reached out to them at my request (my dentist said they never received a call, but Dr. Amin's staff had date, time and notes - love the thoroughness!). After surgery the Dr. called to leave me a message about how it went. Very minimal pain during healing, never any pain during any visits. It took a few tries to get everything just right for the permanent crown (color, etc), but the end result is beyond fantastic! At one point during healing I thought I was experiencing some looseness or wiggling but unfortunately couldn't make it to the office. When I was finally able to make it in the Dr. was so relieved, bless his heart. Luckily it was just a false alarm and everything checked out ok. They're a bit further out from me, but I wanted the best. I sure found it! I wish they were my regular dentist, and I'm looking forward to seeing them again for my check-up which was delayed due to COVID.
Melissa E.
Melissa E.
December 9, 2020.
I found Dr. Amin a few years back after I hadn't been to a dentist in a decade. Many traumatic dental experiences in childhood have made me so phobic that even getting a cleaning was a knee-knocking, heart-pounding trial. But finally I couldn't put off some things any longer. During my first anesthesia session, Dr. Amin replaced five old metal fillings, and during the second he did three more plus a crown. I was completely comfortable, and never felt a thing. Because they were extra-long sessions, I did sleep for about 12 hours after, but the next day I felt just fine. This past week, my back top tooth cracked in half and fell out of my mouth, and a couple days later the crown on the remainder of the tooth fell out too! Despite being nervous about Covid 19, I had to get it taken care of, so I called and quizzed the staff about precautions, which turned out to be even above and beyond what I would have expected. So yesterday I went for the tooth extraction and plug. After they put on the blood pressure cuff and put in the IV, I gradually got a little tired and closed my eyes. I sat there for about 10 minutes and thought Gee, I wonder if they're going to get started any time soon, and a minute later Dr. Amin said "Wake up, you're all done!" That was a short session, and I didn't have the kind of fatigue I did my first time. I stayed up most of the evening. Today, everything is good! I'm taking my antibiotic and eating soft foods, and there is surprisingly little pain now that the numbness has worn off. The tooth site and my cheek are a little sore, and the corner of my mouth, and I have a very slight headache, but nothing to any great level--I'm not even taking the acetaminophen. I feel good, and wide awake. Thanks to everyone at the office for a comfortable and professional job! I really REALLY appreciate you for giving me painless dental experiences!
Tanya S.
Tanya S.
December 3, 2020.
What can I say about Dr. Amin he is the best! I'm so grateful for him. He has literally changed my life and given me the confidence to smile more. I had major restorative dental work done and everything went smoothly. Dr. Amin is very compassionate and he really cares about his patients he made me feel comfortable and cared for. He is very knowledgeable and has a great sense of humor. His office is very clean and they take the patients health and safety very serious. His staff is also amazing they made me feel very welcomed and important. I'm so happy I did my research and found Dr. Amin.  Thank you Dr. Amin and team.
Sheila S.
Sheila S.
November 6, 2020.
Two implants done! Finished all procedures and I couldn't be happier. It's the first time in years I looked forward to going to the dentist. Even during Covid life the staff and Dr. Amin took care of me. There is a possibility I may move to Long Beach but I would still travel to keep Dr. Amin as my dentist.
Allison S.
Allison S.
November 4, 2020.
I could not ask for a more caring, exceptionally knowledgeable dental care provider. He's not just a dentist, but someone who looks after your immediate dental needs and helps you plan and prepare for the future.
Julia R.
Julia R.
October 8, 2020.
I've been going to Dr. Amin since I turned 16 and have been going since. Before going to Dr. Amin's dental office, I had 4 crowns that I was not happy with and dealt with it until finally I asked Dr. Amin and because I  feel comfortable and because I trust him with his work I recently had my crowns fixed and worked on by  Dr. Amin and have never loved my smile the way I do now, I can actually enjoy my pictures, I can enjoy my smile from either angle and that really mattered to me. Thank you so much Dr. Amin still and will be in love with MY smile
Aaron D.
Aaron D.
October 6, 2020.
I've been coming to Dr. Ramsey for about five years and I have to say, he is by far the best dentist I've had - ever. The staff is professional and kind, the office is exceptionally well maintained, and Dr. Ramsey is careful and extremely knowledgeable about current developments and research in dentistry. I recently had a dental implant which was a long process but well worth it. I required a sinus lift as well as a bone graft. The surgery went off without a hitch, I was comfortable and the healing process was quick and without complication. Highly recommend!!
Flo O.
Flo O.
September 21, 2020.
This is my 1st review of Dr. Amin, and in my over 17 years of being with him, my experiences with Dr. Amin and his staff have always been positive.  I don't recall a bad experience with the several implant procedures i have had.  They run an efficient office.  I like that they are proactive and reach out to their patients to remind us of routine care needed.  Dr. Amin's bedside care is impeccable.  They are also technologically up to date in terms of sending out texts as reminders, ability to incorporate any appointment into your mobile phone.  That is certainly a plus.  Keep up the great care!!!