Prescribing Antibiotics in dentistry: clinical insights and implications

Inappropriate use of antibiotics has become a critical global health concern, significantly contributing to the rise of bacterial resistance. This alarming phenomenon represents a threat to public health, as antibiotic-resistant infections become increasingly difficult to treat and life-threatening. In 2019, bacterial antimicrobial resistance was linked to approximately 4.95 million deaths worldwide.

Dentists play a substantial role in antibiotic stewardship, as recent studies indicate that dental prescriptions account for nearly 10% of all oral antibiotic prescriptions—a percentage that has shown little to no decline over time. Prescribing patterns in dentistry often rely on empirical decision-making rather than evidence-based guidelines, leading to overuse, misuse, and inappropriate prophylactic or therapeutic antibiotic administration. This widespread mismanagement exacerbates the development of resistance, highlighting the need for evidence-based prescribing protocols and enhanced education on antimicrobial stewardship to mitigate unnecessary antibiotic use in dental settings.

To complicate the picture, chlorhexidine (CHX), the most widely used antiseptic in dentistry, is commonly applied for oral healthcare in the form of mouthwashes, toothpastes, gels, varnishes, and sprays. However, in recent decades, studies have supported its bacterial resistance to CHX across various species. The possible contribution of CHX to antimicrobial resistance through selective pressure requires thorough evaluation, and further research should investigate CHX resistance and potential cross-resistance with antibiotics in both clinical and environmental isolates.

This talk will provide a comprehensive overview of antibiotic use in dentistry and its clinical implications, including considerations regarding its combined use withCHX.