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Volume 14
Issue 23
10.3390/jcm14238392
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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Review

Patient with Inflammatory Bowel Disease in a Dental Office—Which Antibiotic to Choose?—Narrative Review

by
Stanisław Niemczyk
1,
Wojciech Niemczyk
2,3,*,
Katarzyna Bąk-Drabik
4,
Katarzyna Latusek-Kotyczka
3,
Anna Zawilska
5,
Rafał Wiench
3,
Jakub Hadzik
2,* and
Marzena Dominiak
2
1
Municipal Hospital No. 4 in Gliwice, Zygmunta Starego 20, 44-100 Gliwice, Poland
2
Department of Dental Surgery, Faculty of Dentistry, Wroclaw Medical University, Krakowska 26, 50-425 Wroclaw, Poland
3
Department of Periodontal Diseases and Oral Mucosa Diseases, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, pl. Traugutta 2, 41-800 Zabrze, Poland
4
Department of Pediatrics, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, 40-752 Katowice, Poland
5
Department of Conservative Dentistry with Endodontics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, PlacAkademicki 17, 41-902 Bytom, Poland
*
Authors to whom correspondence should be addressed.
J. Clin. Med. 2025, 14(23), 8392; https://doi.org/10.3390/jcm14238392
Submission received: 29 October 2025 / Revised: 23 November 2025 / Accepted: 24 November 2025 / Published: 26 November 2025
(This article belongs to the Special Issue Clinical Management of Oral Healthcare in Diverse Patient Populations: Second Edition)
Versions Notes

Abstract

Background/Objectives: The rising global prevalence of inflammatory bowel disease (IBD), encompassing Crohn’s disease and ulcerative colitis, has resulted in an increase in the number of affected patients requiring dental care. The heightened risk of Clostridioides difficile infection (CDI) in IBD patients, particularly when exposed to commonly used dental antibiotics, is attributable to their altered gut microbiota and frequent immunosuppressive therapy. The objective of this review is to evaluate current antibiotic strategies for dental management in IBD and to identify safe and effective alternatives that minimise CDI risk. Methods: A narrative review was conducted in accordance with the SANRA guidelines. A comprehensive analysis of literature sourced from PubMed, Embase, Scopus, and Google Scholar was conducted. Results: The available evidence suggests that first- and second-line dental antibiotics—amoxicillin, ampicillin, and clindamycin—carry the highest risk of CDI. In contrast, metronidazole, which exhibits a comparable antimicrobial spectrum, has been shown to possess significantly reduced CDI potential and minimal disruption of gut microbiota. The utilisation of emerging local delivery systems, such as platelet-rich fibrin (PRF), has the potential to further reduce systemic antibiotic exposure. The adjunctive use of probiotics, prebiotics and synbiotics has been demonstrated to have the capacity to maintain microbial balance during therapy. Conclusions: Tailored, microbiome-conscious antibiotic strategies are essential in dental management of IBD patients. Further clinical research is needed to develop evidence-based guidelines and validate promising adjunctive approaches.
Keywords: antibiotic prohylaxis; dentistry; inflammatory bowel diseases antibiotic prohylaxis; dentistry; inflammatory bowel diseases

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MDPI and ACS Style

Niemczyk, S.; Niemczyk, W.; Bąk-Drabik, K.; Latusek-Kotyczka, K.; Zawilska, A.; Wiench, R.; Hadzik, J.; Dominiak, M. Patient with Inflammatory Bowel Disease in a Dental Office—Which Antibiotic to Choose?—Narrative Review. J. Clin. Med. 2025, 14, 8392. https://doi.org/10.3390/jcm14238392

AMA Style

Niemczyk S, Niemczyk W, Bąk-Drabik K, Latusek-Kotyczka K, Zawilska A, Wiench R, Hadzik J, Dominiak M. Patient with Inflammatory Bowel Disease in a Dental Office—Which Antibiotic to Choose?—Narrative Review. Journal of Clinical Medicine. 2025; 14(23):8392. https://doi.org/10.3390/jcm14238392

Chicago/Turabian Style

Niemczyk, Stanisław, Wojciech Niemczyk, Katarzyna Bąk-Drabik, Katarzyna Latusek-Kotyczka, Anna Zawilska, Rafał Wiench, Jakub Hadzik, and Marzena Dominiak. 2025. "Patient with Inflammatory Bowel Disease in a Dental Office—Which Antibiotic to Choose?—Narrative Review" Journal of Clinical Medicine 14, no. 23: 8392. https://doi.org/10.3390/jcm14238392

APA Style

Niemczyk, S., Niemczyk, W., Bąk-Drabik, K., Latusek-Kotyczka, K., Zawilska, A., Wiench, R., Hadzik, J., & Dominiak, M. (2025). Patient with Inflammatory Bowel Disease in a Dental Office—Which Antibiotic to Choose?—Narrative Review. Journal of Clinical Medicine, 14(23), 8392. https://doi.org/10.3390/jcm14238392

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