Skip main navigation

Treating Dental Infections – Procedures and Prescriptions

Dentists can often be too quick to prescribe antibiotics. Watch Dr Julie Guillet explain why this is a problem and how to stop it.
5.8
Hello, and welcome to this e-learning module. What should dentists do for tackling antimicrobial resistance? Antibiotic resistance is a worldwide phenomenon. High levels of resistance have been reported in countries of all income levels. Antibiotic resistance exists everywhere and can infect anyone of any age, in any country. There are currently 700,000 deaths a year from antimicrobial resistant infections. Misuse and abusive use of antibiotics contribute to accelerating the spread of antibiotic resistance. If nothing is done, the number of deaths could achieve 10 million a year in 2050. A recent French study showed that the vast majority of dentists are concerned about antibiotic resistance. However, only 56% of them feel adequately informed about antibiotic use.
71.8
The study of literature shows that a significant proportion of dentists, worldwide, prescribe antibiotics unnecessarily and for incorrect clinical situations. For example, in our French study, dentists declared that inappropriate antibiotic prescriptions for 11 in 17 clinical situations.
95.7
There are several explanations: time pressure in the dental office, patient pressure, anxiety, particularly after surgical procedures. As shown in last week’s learning material, a wide range of non-clinical factors affect the prescribing choices of dentists. We absolutely must tackle these behaviours.
122.2
Tackling resistance in dental offices is possible. First, we must prevent infection. This is probably the better way to not prescribe antibiotics. Teaching people how to avoid infection resulting from tooth decay through diet advice and oral hygiene is better than treating a resulting abscess. And when we do undertake procedures, we and our team have to work in a very hygienic environment, respecting all the rules of asepsis, and antisepsis for both oral surgery and endodontic procedures. Concerning our antibiotic prescriptions, the first rule is to reserve our prescription for situations for which they are really essential. We should use our skills to treat infections, where possible, using procedures rather than prescription.
180.1
For example, an irreversible pulpitis is not a clinical situation which requires antibiotic treatment. And remember, antibiotics don’t replace oral hygiene. Even if I know it’s sometimes difficult, in dental offices, we have to combine drainage of the infectious side with our antibiotic prescription. If we only prescribe antibiotics, without treating the cause of infection, we contribute to increased antibiotic prescriptions, because we know that the infection will start again later on. Lastly, we must respect our local guidelines concerning prophylaxis. Prophylactic antibiotic treatment consists of a single dose of antibiotics one hour before the invasive procedure. We don’t have to combine prophylaxis and curative antibiotic treatment. We do have to make good choices.
243.3
So remember, preventing infection is the first step to combating antibiotic resistance. Thank you very much for your attention.

In this video Dr Julie Guillet recaps the reasons a significant proportion of dentists still prescribe antibiotics unnecessarily. She then goes on to highlight why preventing infections is the best way to to reduce antibiotic prescriptions.

A recent French study showed that whilst the vast majority of dentists are concerned about antibiotic resistance, far fewer feel adequately informed about antibiotic use. A study of literature shows that a significant proportion of dentists worldwide prescribe antibiotics unnecessarily and for incorrect clinical situations. There are many reasons why, such as:

  • Time pressure in the dental office
  • Pressure from patients
  • Anxiety (particularly after surgical procedure)

As shown elsewhere in the course learning material, a wide range of non-clinical factors affect the prescribing choices of dentists – these are the behaviours we must tackle to optimise antibiotic use!

Tackling resistance in dental offices

The best way to reduce antibiotic prescriptions is to prevent infection happening in the first place.

Teaching people how to avoid infection resulting from tooth decay, through diet advice and oral hygiene, is better than treating a resulting abscess. When undertaking procedures, the dental team must work in a very hygienic environment, respecting all the rules of asepsis and antisepsis for both oral surgery and endodontic procedures.

Concerning antibiotic prescriptions, the first rule is to reserve prescription for situations for which they are really essential. Where possible, infections should be treated using procedures rather than prescriptions. For example, an irreversible pulpitis is not a clinical situation which requires antibiotic treatment.

Local guidelines concerning prophylaxis should also be followed. Prophylactic antibiotic treatment consists of a single dose of antibiotic, one hour before the invasive procedure.

So remember, preventing infection is the first step to combating antibiotic resistance.

This article is from the free online

Tackling Antibiotic Resistance: What Should Dental Teams Do?

Created by
FutureLearn - Learning For Life

Our purpose is to transform access to education.

We offer a diverse selection of courses from leading universities and cultural institutions from around the world. These are delivered one step at a time, and are accessible on mobile, tablet and desktop, so you can fit learning around your life.

We believe learning should be an enjoyable, social experience, so our courses offer the opportunity to discuss what you’re learning with others as you go, helping you make fresh discoveries and form new ideas.
You can unlock new opportunities with unlimited access to hundreds of online short courses for a year by subscribing to our Unlimited package. Build your knowledge with top universities and organisations.

Learn more about how FutureLearn is transforming access to education