Antibiotics are crucial in treating infections, but their unnecessary and incorrect use can lead to serious health issues like antibiotic resistance. This is why understanding dentists’ knowledge and practices regarding antibiotic prescription is so important. A recent study in Türkiye evaluated the antibiotic use patterns and awareness levels of 343 dentists, including general practitioners, pediatric dentists, and oral and maxillofacial surgeons. The findings offer valuable insights into the current state of antibiotic prescription in dental care and highlight the need for targeted educational programs to promote more conscious antibiotic use. Antibiotics are a cornerstone of modern medicine, but their overuse and misuse have become a global public health concern. Dentists play a crucial role in this issue, as they frequently prescribe antibiotics to manage dental infections, especially in pediatric patients.
Understanding the Antibiotic Prescription Landscape in Dental Care
The study, conducted by researchers from Karamanoglu Mehmetbey University in Türkiye, aimed to assess dentists’ knowledge, awareness, and prescription practices regarding antibiotic use in pediatric dental infections. The researchers surveyed a diverse group of 343 dentists, including general practitioners, pediatric specialists, and oral and maxillofacial surgeons, to gain a comprehensive understanding of the current landscape.
Demographic Insights and Work Environments
The study participants represented a wide range of professional experiences and work settings. Among the 343 dentists, 202 were general practitioners (58.9%), 98 were pediatric dentists (28.6%), and 43 were oral and maxillofacial surgeons (12.5%). The majority of the dentists (31.8%) worked in university hospitals, while 32.9% practiced in oral and dental health centers. A significant portion (25.9%) also chose to work in private clinics, and 9.3% had their own private practices. This diversity in work environments suggests that dentists’ professional experiences and specializations may vary depending on their workplace.
Antibiotic Prescription Patterns and Awareness
The study revealed several important findings regarding dentists’ antibiotic prescription habits and their awareness of the consequences of indiscriminate use. While most participants (94.9%) recognized antibiotic resistance as a major issue, there were inconsistencies in their prescription practices.
Unnecessary Antibiotic Prescriptions: The study found that a small percentage of dentists (3.8%) prescribed antibiotics to 75-100% of their pediatric patients, which is concerning. In contrast, the majority (47.2%) prescribed antibiotics to less than 5% of their pediatric patients, suggesting a more cautious approach.
Adherence to Guidelines: Most dentists (67.8%) reported that they prescribe antibiotics only when necessary and according to current guidelines. However, a significant portion (29.2%) acknowledged that patient demands and inadequate appointment times influenced their decision to prescribe antibiotics, indicating a potential lack of adherence to clinical guidelines.
Awareness of Consequences: The dentists demonstrated a good understanding of the consequences of indiscriminate antibiotic use, with the majority identifying antibiotic resistance (94.9%), disruption of gut flora (84.8%), kidney dysfunction (76.9%), and liver dysfunction (76%) as potential issues. However, awareness of other consequences, such as the weakening of the immune system (62.3%) and the development of allergies (60.8%), was lower.
Antibiotic Prescription Practices in Specific Clinical Scenarios
The study also explored dentists’ antibiotic prescription practices in various clinical scenarios involving pediatric dental infections. The responses revealed both consistent and inconsistent approaches:
Irreversible Pulpitis: The majority of dentists (84.4%) correctly identified that antibiotics are unnecessary for children with symptomatic irreversible pulpitis, reflecting an appropriate understanding of when antibiotics are not required.
Necrotic Pulp: Similarly, 91.5% of the participants stated that antibiotics are not needed for children with necrotic pulp without systemic infection symptoms, demonstrating a strong grasp of when antibiotic use is not indicated.
Apical Periodontitis: However, for cases of acute apical periodontitis with percussion sensitivity and widened periodontal space, the responses were more divided, with 50.1% of dentists considering antibiotics necessary and 42.8% considering them unnecessary. This suggests a need for clearer guidelines and further education in this specific scenario.
Chronic Apical Periodontitis: Interestingly, more experienced dentists (with over 5 years of practice) were more likely to recommend antibiotics for chronic apical periodontitis with a fistula, compared to their less experienced counterparts. This highlights the potential impact of clinical experience on decision-making in certain situations.
Promoting Responsible Antibiotic Use in Dental Care
The findings of this study emphasize the critical need to strengthen educational programs and guidelines for dentists to promote more conscious and responsible antibiotic use. While the majority of participants demonstrated a good understanding of the consequences of indiscriminate antibiotic use, the inconsistencies in prescription practices, particularly in certain clinical scenarios, suggest that more targeted interventions are necessary.
Improving Adherence to Guidelines: Addressing the factors that lead dentists to prescribe antibiotics due to patient demands or time constraints is crucial. Enhancing patient education and improving time management in clinical practice could help dentists adhere more closely to evidence-based guidelines.
Continuous Professional Development: The study also highlights the importance of continuous professional development, as more experienced dentists demonstrated different approaches in certain clinical situations compared to their less experienced counterparts. Providing ongoing training and support for dentists, especially in areas where inconsistencies were observed, can help standardize antibiotic prescription practices.
Combating Antibiotic Resistance: A Collaborative Effort
Addressing the issue of antibiotic resistance in dental care requires a multifaceted approach involving dentists, policymakers, and the broader healthcare community. By promoting responsible antibiotic use through education, strengthening clinical guidelines, and fostering collaboration, we can work towards more effective infection management and the preservation of these vital medical resources for generations to come.
Author credit: This article is based on research by Elif Esra Ozmen, Tuğçe Nur Sahin.
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