FYI

Dr. Allen Edwards, fondly known as Dr. Al, is the Principal Advisor for Government Programs at Delta Dental and the author of this article. He is a seasoned health care professional with expert knowledge of the U.S. Congress, the Department of Defense (DOD) and Federal health care laws and policy. Senior members of Congress and the Executive Branch have trusted him to craft and oversee complex health care, education and commercial resale legislation for the largest Federal agency, the DOD.

In 1928, Alexander Fleming, a Scottish bacteriologist, discovered penicillin when he noticed a mold, Penicillium Notatum, killed bacteria in a petri dish that he left uncovered. Fleming’s early discovery led to many years of further penicillin research and development until the U.S. and British governments prioritized its production for use during World War II. Since those early years in Fleming’s lab, over 100 antibiotics of various classes have been developed and approved for human use.  

Antibiotics have saved countless lives in the last 80+ years, and in dentistry, we’ve used them to manage or prevent infections, in post-surgical care and to support patients with systemic health conditions. Indiscriminate use of antibiotics in dental practices, however, leads to antibiotic resistance, which can result in dental and medical treatment failure, higher health care costs for our patients, and further spread of antibiotic resistance among communities where we live.

As dental professionals, we must do our part to combat antibiotic resistance by incorporating antibiotic stewardship principles — responsibly prescribing antibiotics to treat dental infections — within our practices. The American Dental Association (ADA) has published  treatment guidelines for the appropriate use of antibiotics in dental practices emphasizing that dentists should only prescribe antibiotics when there is clear evidence of a bacterial infection. The guidelines encourage us to treat common dental conditions like irreversible pulpitis or localized abscesses with dental treatment alone without prescribing antibiotics.

When antibiotics are required, ensure that you prescribe the right drug, the right dose and right duration. Don’t use broad spectrum antibiotics unless indicated; narrow spectrum drugs like amoxicillin should be your first choice, and prescribed with limited duration, typically three to five days. Finally, inform patients to adhere to the antibiotic regimen you prescribed and ensure they understand the risks of antibiotic resistance. If we all strive to follow the ADA’s guidelines, we’ll help to ensure that first-line antibiotics remain effective for our patients.