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Dental EconomicsAntibiotics in Dentistry: Think Twice Before Prescribing

Dentistry needs to take antibiotic resistance seriously in light of the alarming data. Here’s what you should know regarding overprescribing, ADA recommendations for dental antibiotics, non-traditional therapies, and more.

The rise of antibiotic-resistant bacteria poses a significant challenge to healthcare, including dentistry. A recent report from the CDC highlights the urgency of the situation, emphasizing the need for responsible antibiotic prescribing practices. Dentists, as significant prescribers of antibiotics, have a crucial role to play in mitigating this crisis.

HCN Medical Memo
For the dental community, the rise in antibiotic resistance is not just a general healthcare issue but a direct call to action. The new ADA guidelines provide a roadmap for responsible antibiotic use. It’s imperative to not only follow these guidelines but also to explore alternative treatments and educate patients about the risks and limitations of antibiotic use. The stakes are high, and the dental community must be part of the solution.

Key Points:
  • The CDC reports that antibiotic-resistant bacteria infect someone in the US every 11 seconds and result in a death every 15 minutes.
  • Clostridioides difficile (C. diff) infections are particularly problematic, affecting nearly half a million people annually in the US and proving resistant to most antibiotics.
  • Dentists are the third-highest prescribers of antibiotics in all outpatient settings in the US and the leading prescribers of clindamycin, which is closely associated with C. diff infections.
  • The American Dental Association (ADA) has released new guidelines advising against the use of antibiotics for most pulpal and periapical conditions.

“Evidence suggests that antibiotics for the target conditions may provide negligible benefits and probably contribute to large harms. The expert panel suggests that antibiotics for target conditions be used only when systemic involvement is present and that immediate DCDT (definitive, conservative dental treatment) should be prioritized in all cases.”
– ADA Guidelines

Additional Points:
  • The CDC estimates that 30%–50% of antibiotics are unnecessarily or incorrectly prescribed in hospital settings. A review found the overuse in dentistry to be as high as 80%.
  • Alternate treatment modalities like the use of hydrogen peroxide have shown promise in treating bacterial-based diseases in dentistry.
  • Patient education is crucial for effective antibiotic stewardship.

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