Antibiotic Prescriptions Given to Prevent Dental Infections Often Unnecessary: Study

Despite known risks associated with unnecessary use of antibiotics, a new study suggests that the medications are overprescribed following dental procedures more than 80% of the time, placing patients at risk and contributing to the emergence of antibiotic resistant bacteria.

In a study published last week in the medical journal JAMA Network Open, researchers with the University of Illinois at Chicago report that only about 20% of the preventive antibiotic prescriptions written for dental procedures were actually needed. Yet many more are written every year simply for preventive measures, which are not based on actual risk.

Researchers analyzed data from more than 91,000 patients who received preventive antibiotics for 168,420 dental visits from 2011 to 2015. The participants did not have a hospitalization or infection 14 days before dental treatment, which would require antibiotics for another purpose.

The data indicates only 21% of the prescriptions given, roughly 31,000 prescriptions, were necessary, because the patient faced a serious risk of endocarditis, which is an infection of the heart valves. The bacteria typically spreads to the heart through the bloodstream from another part of the body, including the gums and mouth, such as during dental work.

Some patients face a higher risk of this condition, so dentists give them preventive antibiotics. Patients who have joint replacements or cardiac conditions face a higher risk, especially if they will undergo procedures that involve the gums or the root of a tooth, such as root canal.

In this study, researchers noted only 21% of patients were at high risk for endocarditis. Thus, 80% of the preventive prescriptions given to patients undergoing dental procedures were not necessary and prescribed inappropriately.

Most patients prescribed antibiotics inappropriately were women and over-prescription most commonly occurred in the Western United States.

This isn’t the first study to show antibiotics are widely overprescribed for situations where they are not called for, despite the known risks.

In 2017, a different study linked inappropriate dental antibiotic prescriptions to the spread of Clostridium difficile (C. diff), an infection that is highly resistant to antibiotics, but becoming more common in recent years.

A recent United Nations report warned the overuse of antibiotics is leading to the evolution of superbugs which are not treatable by antibiotics. The creation of these superbugs is outpacing the development of new antibiotics, leading to hundreds of thousands of deaths globally each year.

Since dentists write approximately 10% of all antibiotic prescriptions in the country, focusing on when inappropriate prescribing occurs is crucial to reducing antibiotic overuse, researchers said.