OSAP Safest Dental Visit™: Antibiotic Use in Dentistry

In September 2016, the Organization for Safety, Asepsis and Prevention (OSAP) a growing community of clinicians, educators, policy makers, consultants and industry representatives who advocate for the Safest Dental Visit™, celebrated the second annual Dental Infection Control Awareness Month (DICAM) to focus on the importance of infection control in dentistry. In this month’s Efficiency in Group Practice, we look at the importance of best practices to ensure responsible antibiotic use in dentistry.

Researchers and clinicians have long agreed that a substantial percent of outpatient antibiotic prescriptions – as much as 30 percent – is unnecessary. Due to barriers in data collection, however, it has been unclear exactly how much unnecessary antibiotic prescribing takes place in dentistry. Still, there is concern that unnecessary and inappropriate prescribing is common in dental offices. Data show that primary care dentists – not including dental specialists or surgeons – write approximately 10 percent of all antibiotic prescriptions filled in outpatient pharmacies each year. That equates to nearly 26 million prescriptions.

The Centers for Disease Control and Prevention (CDC) and the Organization for Safety, Asepsis and Prevention (OSAP) recently collaborated on an article –Considerations for Responsible Antibiotic Use in Dentistry – published in The Journal of the American Dental Association (JADA) concerning responsible antibiotic use in dentistry. Authors Marie T. Fluent, DDS; Peter L. Jacobson, PhD, DDS, Dip ABOM; and Lauren A. Hicks, DO, point out that “misuse and overuse of antibiotics have contributed to selective pressure on bacteria to adapt to the antibiotics intended to kill them; antibiotic resistance is now one of our most serious global health threats. Every year in the United States, at least two million people become infected with antibiotic-resistant bacteria, and approximately 23,000 people die as a direct result of these infections.”

Subhead: Best practices
In an effort to improve antibiotic use in dentistry, several professional organizations have developed best practices to guide dentists through the entire antibiotic prescribing process, including pretreatment, prescribing and patient and staff education. Pretreatment steps involve establishing a correct diagnosis, reviewing the patient’s pertinent medical history and considering whether therapeutic management of a local bacterial infection with a procedure may be more appropriate than using an antibiotic. Dentists should base their prescribing decisions on evidence-based medicine. Additionally, they should educate patients to take antibiotics exactly as prescribed – and only if prescribed for them – and to not save unused antibiotics for future use. Lastly, dentists and staff should stay current on optimal antibiotic prescribing practices through continuing education opportunities.

Dental organizations such as OSAP and the American Dental Association (ADA), have committed to improving antibiotic prescribing in order to maximize patient safety and reduce antibiotic overuse and misuse. Antibiotic overuse and misuse have been known to contribute to the development and spread of antibiotic resistance and the occurrence of adverse events, such as the sometimes-deadly diarrhea caused by Clostridium difficile. These best practices will be a resource for dentists to consult when prescribing antibiotics to ensure patients are prescribed antibiotics only when the benefits outweigh the risks.

OSAP will feature a session on antibiotic stewardship in dentistry at its annual conference June 22-25 in Atlanta, Ga. For more information visit http://osapconference.org.

Editor’s note: To review the article visit http://jada.ada.org/article/S0002-8177(16)30409-3/abstract?rss=yes.

OSAP looks forward to continuing to work with the CDC to help advance its antibiotic-resistance initiative. To learn more, visit the CDC Safe Healthcare Blog:

http://blogs.cdc.gov/safehealthcare/addressing-antibiotic-resistance-in-dentistry-what-can-we-do/.

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