ADA Guidelines Update for the INBDE (Trauma + Prophylaxis)
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Table of Contents
    Key Takeaway

    Previous guidelines (still in effect for current INBDE, and the correct answer): 

    • HBSS is the best storage medium for avulsed teeth.
    • Clindamycin can still be prescribed for antibiotic prophylaxis.

    New guidelines (not in effect for INBDE yet, but we will update you when they go in effect):

    • Milk is the best storage medium for avulsed teeth.
    • Clindamycin is no longer recommended for antibiotic prophylaxis.

    With new information always being gathered, guidelines on how to treat patients can change over time. Bootcamp.com is working behind the scenes to provide you with the most updated information to help you prepare for your exam!

    Two major updates have occurred recently that affect dental practice: how to handle avulsed teeth, and antibiotics for use in prophylaxis. 

    Update #1: Milk is the preferred storage medium for avulsed teeth.

    In 2020, the International Association of Dental Traumatology (IADT) released updated guidelines for the evaluation and management of traumatic dental injuries. 

    Previously, Hank’s balanced salt solution (HBSS) was the recommended storage medium for avulsed teeth. However, in 2020, the guidance was updated to specify that in “descending order of preference, milk, HBSS, saliva (after spitting into a glass for instance), or saline are suitable and convenient storage mediums”.

    (https://onlinelibrary.wiley.com/doi/full/10.1111/edt.12573)

    Update #2: Clindamycin is no longer recommended for antibiotic prophylaxis.

    In 2021, the American Heart Association (AHA) released a new scientific statement no longer recommending the use of clindamycin for antibiotic prophylaxis due to its high risk of Clostridium difficile infection, and the high morbidity and mortality associated with it.

    (https://www.ahajournals.org/doi/pdf/10.1161/CIR.0000000000000969)

    In spite of these updates, the American Dental Association has a pipeline for producing new questions and making updates to them. Therefore, not all of the latest recommendations are automatically reflected on today’s INBDE

    Reply from INBDE

    As of now the updates have not been implemented and the exact date of implementation will be provided as soon as it is known. Until that time, all of our questions reflect the guidelines the ADA is currently using (which are the old guidelines). 

    We will continue to communicate with the ADA to provide updates to you about these changes and when they go live.

    ADA Guidelines Update for the INBDE (Trauma + Prophylaxis)
    ADA Guidelines Update for the INBDE (Trauma + Prophylaxis)
    With new information always being gathered, guidelines on how to treat patients can change over time. Two major updates have occurred somewhat recently that affect dental practice: how to handle avulsed teeth and antibiotics for use in prophylaxis. 
    October 3, 2022
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    Kylie Carganilla, Bootcamp.com Student