Working Together to Find Solutions

Minimising resistance and achieving the best possible use of antibiotics is the joint responsibility of all disciplines working in the health care sector. Interdisciplinary cooperation is a necessity, but such cooperation on its own is not enough. It’s also the responsibility and duty of the government to reduce the use of antibiotics as much as possible. Human health cannot, however, be viewed separately from animal health. Veterinarians as well as human health care professionals must become aware of the danger of the use of antibiotics. Cooperation on the basis of the One Health principle is key, with antibiotic stewardship being necessary to engender the responsible use of antibiotics. Prevention plays an important role in reducing the use of antibiotics.

This is especially the case in dentistry. Dental health must be an objective from day one. The health centre must begin to provide good information to young mothers with the emphasis on a healthy diet and dental care. Naturally, schools should also provide information directly to the children themselves. It’s important for visits to the dentist and dental hygienist to become a matter of routine from as young an age as possible. Parents need to feel motivated to ensure that a child does not consume excessive amounts of sugar and brushes regularly with a fluoride toothpaste. A healthy mouth requires a healthy lifestyle and regular visits to the dentist.

The government has the key task of making the population aware of how a healthy lifestyle promotes health. Information is needed on the risk association with the excessive use of sugar– not only for your teeth, but also in terms of diseases such as obesity and how obesity can lead to other health problems. It’s also important to inform the population of the dangers associated with the irresponsible use of antibiotics and to point out the dangers of antibiotic resistance. Recognising that human health is related to animal health and our environment, the Dutch government has included the One Health approach in its national action plan on antimicrobial resistance.

As regards the human health care sector, the government has agreed to cut back antibiotic use by halving the necessary prescriptions within five years. The Royal Dutch Dental Association has responded to this challenge by starting development of its antibiotic stewardship programme, focusing on the theme of patient safety using a multidisciplinary approach.

It begins by introducing antibiotics into its programme of continuous professional education - the IQual. Dentists were invited to attend lectures by doctors and pharmacists about the responsible use of medication and how dentists can contribute to the prevention of resistance. The next step, developing guidelines specifically for dentists, has been undertaken by the Dutch Knowledge Institute of Oral Healthcare, the KIMO. Reflecting the fact that partnership and collaboration form an important element of the Dutch approach to dental antimicrobial stewardship, KIMO is an association made up of the Royal Dutch Dental Association (the KNMT), the Association of Dutch Dentists (the ANT), and the Federation of Scientific Associations in Dentistry.

Funding for the guidelines were raised via KIMO members, supplemented by the Ministry of Health, following an initial phase of assessing and evaluating the challenges. Regarding antibiotic use in the Netherlands, priorities have now been set which form the basis for the development of our EMR guidelines. To summarise, tackling antibiotic resistance is a complex issue which requires a range of disciplines to work together. The Dutch government has included a target relating it to dentistry in its national action plan. And, by working in partnership with pharmacists, medics, and various dental scientific groups, we are actively working towards delivering it. Reducing dental antibiotic use by 50% will be tough, but we have a plan and we are taking the first steps.