Inappropriate Antibiotic Prescribing Patterns in Dental and Emergency Settings: Individual and Overall Impact

Dentists encounter many intraoral conditions that may be caused by bacteria where antibiotic prescriptions may be warranted and beneficial. Bacteria associated with caries can cause acute inflammation of pulpal tissue including symptomatic irreversible pulpitis, which may progress to pulpal necrosis with or without symptomatic apical periodontitis.¹⁶ Dentists may also perform procedures that can introduce oral bacteria into local or systemic spaces and/or foreign bodies/substances into the oral environment. The bacterial basis of a multitude of oral conditions result in dentists prescribing antibiotics either in response to acute dental pain and/or conditions or prophylactically to prevent infections after dental procedures. Dentists overall write the third highest number of antibiotic prescriptions in outpatient healthcare settings. ² It is estimated, however, that between 30-85% of dental antibiotic prescriptions are “suboptimal or not indicated.^3-5