Treating Dental Infections - Procedures and Prescriptions

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.