Management of odontogenic infections in primary teeth

Despite improved dental health, odontogenic infections originating from primary teeth are a frequent occurrence in daily clinical practice. Due to existing limitations in the implementation of endodontic treatment measures in childhood, the extraction of pain-causing or avital primary teeth is usually the procedure of choice. In the acute phase, the indication for antibiotic administration has often been discussed. With reference to the latest recommendations of the European Society of Endodontology (ESE; 2017) 1 and the guidelines of the German Paul Ehrlich Society for Chemotherapy (PEG; 2018) 2, the indication for the use of antibiotics is limited to odontogenic infections with systemic involvement, or where there is gross, rapid or diffuse spread of infection from neighbouring loci. Phenoxymethylpenicillin is the antibiotic of choice for primary teeth. In the case of permanent teeth or antibiotically pretreated odontogenic infection, the administration of amoxillin/clavulanic acid is preferred.