Antibiotic Prescribing in Dentistry

Oliver Cunningham • 4 minute read • April 24, 2025

Antibiotics are essential for combating bacterial infections in oral surgery, but their overuse contributes to antibiotic resistance and other complications. A significant portion of antibiotic prescriptions in dentistry may be inappropriate due to poor adherence to prescribing guidelines. This study aimed to evaluate the appropriate use of antibiotics in oral surgery, considering the growing importance of antimicrobial stewardship and emerging alternative therapies.

Antibiotic resistance is a growing global health threat, and C. difficile infection is a potential complication of inappropriate antibiotic use. Antibiotics can also have side effects, including allergic reactions and digestive issues. The oral microbiome plays a crucial role in oral health, and disrupting it with unnecessary antibiotics can have negative consequences.

The Royal College of Surgeons of England and the Scottish Dental Clinical Effectiveness Programme provide guidelines for antibiotic use in oral surgery. These guidelines outline recommendations for specific diagnoses and appropriate antibiotics. Adhering to these guidelines helps ensure appropriate and safe antibiotic prescribing.

Accurate diagnosis is crucial for appropriate antibiotic selection. Consider patient symptoms, clinical presentation, and potential underlying conditions. Antibiotics are indicated for severe infections like dentoalveolar abscesses, pericoronitis, and necrotizing periodontal disease, especially when accompanied by systemic symptoms. Local measures, like incision and drainage, should be combined with antibiotics to enhance infection management. Avoid unnecessary antibiotic use by limiting prescriptions to cases where local measures suffice or for routine procedures.

Antimicrobial stewardship involves accurate diagnosis, appropriate antibiotic selection, correct dosage, and patient education. Adhering to these principles helps combat antibiotic resistance and other complications.

Alternative therapies like antimicrobial dental materials, photodynamic therapy, and probiotics offer promising alternatives to antibiotics. Antimicrobial dental materials incorporate antimicrobial agents to prevent bacterial attachment and biofilm formation. Photodynamic therapy utilizes light to kill bacteria within biofilms. Probiotics and prebiotics promote a healthy gut microbiome, reducing susceptibility to infections and mitigating antibiotic side effects.

By embracing antimicrobial stewardship and exploring alternative therapies, oral surgery can optimize patient outcomes while preserving the effectiveness of antibiotics for future generations. Accurate diagnosis, targeted antibiotic use, and patient education are key components of responsible antibiotic prescribing in dentistry.