When is antibiotic prophylaxis recommended in periodontal surgery?

Antibiotic prophylaxis is recommended in periodontal surgery mainly when it is medically necessary, particularly for patients who have specific health considerations that put them at increased risk for infectious complications. This approach aligns with current clinical guidelines, which indicate that not all patients require prophylactic antibiotics; instead, it's based on individual risk factors such as a history of infective endocarditis, certain heart conditions, or compromised immune systems.

For patients without these risk factors undergoing routine periodontal surgery, the use of antibiotics may not only be unnecessary but could also contribute to the development of antibiotic resistance, increase the risk of adverse drug reactions, and lead to unnecessary healthcare expenditures. The focus on the necessity of antibiotics ensures that they are utilized judiciously and only when the potential benefits outweigh the risks.

In contrast, administering antibiotics as a standard for all patients, before any surgical procedure, or only after surgery does not take into account the individual health status of patients and could lead to overprescription. The tailored approach in option B supports both effective patient care and responsible clinical practice.