GuidelineJournal of the American Dental Association (1939)2019
Evidence-based clinical practice guideline on antibiotic use for the urgent management of pulpal- and periapical-related dental pain and intraoral swelling: A report from the American Dental Association.
Guideline in Journal of the American Dental Association (1939), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 115 papers, 8 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
115 citing papers in PubMed, 8 syntheses or guidelines pooled it, 199 citations in OpenAlex.
- Evaluating Reporting Completeness in Oral Health Clinical Guidelines: A Meta-Research Study.JDR clinical and translational research · 2026Pooled it
- Clinical Practice Guideline for Evaluation and Management of Peripheral Nervous System Manifestations in Sjögren's Disease.Arthritis care & research · 2026Guideline
- Evidence-based clinical practice guidelines for the management of acute dental pain.The American journal of emergency medicine · 2025Guideline
- Systemic antibiotics for symptomatic apical periodontitis and acute apical abscess in adults.The Cochrane database of systematic reviews · 2024Pooled it
- Evidence-based clinical practice guideline for the pharmacologic management of acute dental pain in adolescents, adults, and older adults: A report from the American Dental Association Science and Research Institute, the University of Pittsburgh, and the University of Pennsylvania.Journal of the American Dental Association (1939) · 2024Guideline
- Assessment of the Quality of Current American Dental Association Clinical Practice Guidelines.JDR clinical and translational research · 2023Pooled it
- Outcomes to evaluate care for adults with acute dental pain and infection: a systematic narrative review.BMJ open · 2022Pooled it
- Antibiotics for the urgent management of symptomatic irreversible pulpitis, symptomatic apical periodontitis, and localized acute apical abscess: Systematic review and meta-analysis-a report of the American Dental Association.Journal of the American Dental Association (1939) · 2019Pooled it
- Antibiotics after non-surgical root canals: National Dental Practice-Based Research Network findings.Journal of dentistry · 2026Article
- Third‑molar extraction: do antibiotics really prevent postoperative infection?Evidence-based dentistry · 2026Article
- Assessing Knowledge, Attitude, and Practices of Dentists on Antibiotic Use for Pediatric Dental Infections in Bangladesh: A Cross-Sectional Study.Health science reports · 2026Article
- Reassessing Antibiotic Duration in Dental Infections: A Narrative Review and Marginal Benefit-Harm Framework with a Clinical Checklist.Antibiotics (Basel, Switzerland) · 2026Review
- Dental Antibiotic Prescribing Practices and Antimicrobial Resistance Knowledge in Singapore.International dental journal · 2026Article
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- From Caries to Periodontal Breakdown: A Biological and Clinical Continuum Linking Cariology, Operative Dentistry, Endodontics, and Periodontology.Dentistry journal · 2026Review
- Management of acute dental pain in adults.Canadian family physician Medecin de famille canadien · 2026Article
- Tooth survival following pulpectomy in primary molars with apical periodontitis and preoperative factors associated with failure: a retrospective cohort study.BMC oral health · 2026Article
- Potential Association Between Apical Periodontitis and Cardiovascular Disease: A Narrative Review of Evidence and Clinical Implications.Anatolian journal of cardiology · 2026Review
- Sustained Improvement in Antibiotic Prescribing Among Private Practice Dentists Following Antibiotic Stewardship Education and Dashboard Implementation.Open forum infectious diseases · 2026Article
55 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
17 authors.
Funding
Abstract
backgroundAn expert panel convened by the American Dental Association Council on Scientific Affairs and the Center for Evidence-Based Dentistry conducted a systematic review and formulated clinical recommendations for the urgent management of symptomatic irreversible pulpitis with or without symptomatic apical periodontitis, pulp necrosis and symptomatic apical periodontitis, or pulp necrosis and localized acute apical abscess using antibiotics, either alone or as adjuncts to definitive, conservative dental treatment (DCDT) in immunocompetent adults. TYPES OF STUDIES REVIEWED: The authors conducted a search of the literature in MEDLINE, Embase, the Cochrane Library, and the Cumulative Index to Nursing and Allied Health Literature to retrieve evidence on benefits and harms associated with antibiotic use. The authors used the Grading of Recommendations Assessment, Development and Evaluation approach to assess the certainty in the evidence and the Evidence-to-Decision framework.
resultsThe panel formulated 5 clinical recommendations and 2 good practice statements, each specific to the target conditions, for settings in which DCDT is and is not immediately available. With likely negligible benefits and potentially large harms, the panel recommended against using antibiotics in most clinical scenarios, irrespective of DCDT availability. They recommended antibiotics in patients with systemic involvement (for example, malaise or fever) due to the dental conditions or when the risk of experiencing progression to systemic involvement is high. CONCLUSION AND PRACTICAL IMPLICATIONS: Evidence suggests that antibiotics for the target conditions may provide negligible benefits and probably contribute to large harms. The expert panel suggests that antibiotics for target conditions be used only when systemic involvement is present and that immediate DCDT should be prioritized in all cases.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.