Demographic Factors Associated with Antibiotic Use for Patients Undergoing Extraction of Primary Teeth in the Emergency Department

Background The purpose of this study was to understand antibiotic use in families presenting to the emergency department (ED) for odontogenic infection secondary to facial swelling requiring primary tooth extraction under sedation.Methods A retrospective, observational study was completed at a tertiary-care children’s hospital with a dental residency program. Children were identified through dental resident clinical logs from March 2021 to June 2023. Patients aged 1–13 years seen in the ED for extraction of a primary tooth due to odontogenic infection with facial swelling under sedation were included.Results In a multivariable logistic regression, gender (for the purpose of this paper, gender refers to biological sex) and race were significantly associated with the absence of antibiotic use in patients presenting with facial swelling due to odontogenic infection. The odds of female patients not using antibiotics were approximately 80% lower than those of their male counterparts. Compared with Caucasians, African American (AA) patients had 82% high odds of having antibiotic use.Conclusions Health inequities likely contribute to the significant difference in prior antibiotic use in Black/African American children presenting to the ED with facial swelling due to odontogenic infection. Female patients have been identified in some literature to have greater anxiety surrounding dental procedures. This may lead to infrequent/inconsistent dental care or inability to complete care without the use of an advanced dental management technique, which may explain the significant difference in odds in female patients presenting to the ED with facial swelling on antibiotics.Practical Implications Antibiotic prescription with odontogenic infection.