LONDON, UK: To help dental teams play their part in tackling the problem of antimicrobial resistance, the College of General Dentistry and Faculty of Dental Surgery of the Royal College of Surgeons of England have jointly published guidelines on antimicrobial prescribing in dentistry. The current third edition was published in 2020, and a new one-page synopsis of the recommendations for treating oral infections has recently been made available for all dental professionals online.
According to the World Health Organization, the main causes of the development of drug-resistant pathogens are the misuse and overuse of antimicrobials, and it has declared antimicrobial resistance one of the top ten global public health threats.
The guidelines offer simple and practical information on the use of antimicrobials to educate dental teams about the management of oral and dental infections. The novel one-page summary outlines recommended treatments for seven types of infection, including dental abscesses, periodontal abscesses, necrotising periodontal disease, acute pulpitis and peri-implantitis. In addition, it provides information on indications for the use of antimicrobials and the first-choice antimicrobial where use is indicated, including dosages and duration of intake for adult patients.
For recommendations on other conditions, second-choice antimicrobials (for example for patients who are allergic to penicillin), dosages for children and hospitalised patients, treatment of medically compromised patients and prophylactic prescribing to prevent infections, dental teams should refer to the full guidelines.
Dr Wendy Thompson, lead developer of the new summary and the College of General Dentistry’s lead on antimicrobial stewardship, commented in a press release: “The scale of the problem of antibiotic-resistant bacterial infections cannot be overstated. They already kill more people worldwide than HIV and malaria combined, and they will cause more deaths than cancer within a generation.”
She added: “By prescribing antibiotics only when strictly necessary, dental practitioners can keep antibiotics working and ultimately save lives. Using the new synopsis as an aide memoire, and referring to the full guidelines as necessary, will help them to do so.”
Matthew Garrett, dean of the Faculty of Dental Surgery of the Royal College of Surgeons of England, said: “Our new one-page synopsis outlines treatment recommendations for a number of infections commonly encountered by dental practitioners, and makes it easy to access the full, detailed, condition-by-condition guidelines document, which is freely available online for the benefit of all dental professionals and their patients.”
The full guidelines, titled Antimicrobial Prescribing in Dentistry: Good Practice Guidelines, are available online free of charge after registration on the college website. The one-page synopsis is available online free of charge without registering.
Other helpful tools
In addition to the guidelines, the College of General Dentistry has created the Antimicrobial Prescribing Self-Audit Tool with which dental professionals can manage their antimicrobial prescribing and can compare their practices with the guidelines. The audit tool has been published in cooperation with the British Dental Association (BDA) and endorsed by Public Health England and can be downloaded here.
Dental practices can find further information, resources and training tools in the Dental Antimicrobial Stewardship Toolkit, which was developed by the dental subgroup of Public Health England’s English surveillance programme for antimicrobial utilisation and resistance, the Faculty of General Dental Practice and the BDA.