8th Q&A With Dr. Richard Bernstein

Diabetics with dental infection should have a longer course of antibiotics, up to a year. Is there an optimal timing of antibiotic that should be used?

First of all, it varies with the person. If your blood sugars are going to be high because you’re not using precise blood sugar control, you are going to need the antibiotic for a longer period of time.

When one of my patients needs a procedure, I look at their blood sugars to make sure they are essentially normal. They have the procedure, and they are put on an antibiotic. We may stop it in a month. If their blood sugars go up, they still have the infection, and we continue the antibiotic. We may stop it then in another two months, and if their blood sugar goes up, we continue, etc.  Frequently we must continue antibiotics (and probiotics) for a year. 

The reason for this antibiotic protocol is a condition called osteomyelitis, which is infection in a bone. It’s usually an infection in the jawbone that is transmitted from a tooth or gum infection.  An endodontist usually discovers a root canal infection by looking for a loss of bone in the adjacent jaw bone. Osteomyelitis is very hard to cure because the levels of antibiotic are always much lower in the bone than levels in the blood stream.



Richard K. Bernstein, MD is one of the most knowledgeable, committed and successful pioneers in the field of diabetes today.  He invented blood sugar self-monitoring  and basal/bolus insulin dosing, when he was an engineer.

Dr. B is Director Emeritus of the Peripheral vascular Disease Clinic of the Albert Einstein College of Medicine. His private medical Practice in Mamaroneck N. Y. specializes in treating diabetes and obesity.

He is a physician, research scientist, thriving Type 1 for  67 years, and best-selling author of nine  diabetes books including Diabetes  Solution , The Diabetes Diet and several E-books. This link diabetes-book.com will give you more information about his publications. To  sign up for his free monthly teleseminars, visit askdrbernstein.net.

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