Antibiotics or No Antibiotics, That Is the Question: An Update on Efficient and Effective Use of Antibiotics in Dental Practice

Abstract

The antimicrobial resistance (AMR) phenomenon is an emerging global problem and is induced by overuse and misuse of antibiotics in medical practice. In total, 10% of antibiotic prescriptions are from dentists, usually to manage oro-dental pains and avoid postsurgical complications. Recent research and clinical evaluations highlight new therapeutical approaches with a reduction in dosages and number of antibiotic prescriptions and recommend focusing on an accurate diagnosis and improvement of oral health before dental treatments and in patients’ daily lives. In this article, the most common clinical and operative situations in dental practice, such as endodontics, management of acute alveolar abscesses, extractive oral surgery, parodontology and implantology, are recognized and summarized, suggesting possible guidelines to reduce antibiotic prescription and consumption, maintaining high success rates and low complications rates. Additionally, the categories of patients requiring antibiotic administration for pre-existing conditions are recapitulated. To reduce AMR threat, it is important to establish protocols for treatment with antibiotics, to be used only in specific situations. Recent reviews demonstrate that, in dentistry, it is possible to minimize the use of antibiotics, thoroughly assessing patient’s conditions and type of intervention, thus improving their efficacy and reducing the adverse effects and enhancing the modern concept of personalized medicine.

ESBL/AmpC-Producing Escherichia coli in Wild Boar: Epidemiology and Risk Factors

“…The high prevalence of ESBL/AmpC-producing E. coli recorded in wild boar in this study leads to strategies for reducing and preventing the spread of resistant bacteria in the environment and between species. As the main concern of AMR is related to the overuse of antimicrobials [43], the reduction of antibiotic administration in domestic animals should be the starting point. In addition, farm biosecurity standards and infrastructure should be improved in order to minimize the impact of animal husbandry manure in the environment and to prevent the related potential spreading of AMR bacteria.…”

Next-Generation Sequencing Analysis of Root Canal Microbiota Associated with a Severe Endodontic-Periodontal Lesion

“…Extraction of tooth 1.7. was planned two days after the first visit because the tooth was periodontally severely compromised and symptomatology was worsening, hindering any periodontal or endodontic treatment [20]. Non-surgical periodontal treatment with ultrasonic tips to remove dental biofilms and pre-operative mouthwash with chlorhexidine 0.20% for 60 s to reduce bacterial load were applied, and the tooth was anesthetized locally with articaine and adrenaline 1:100,000.…”

A Case of Infective Endocarditis Due to Oral Streptococci After Perioperative Oral Function Management

“…It is known that transient bacteremia occurs even with daily brushing and eating [ 1 ], but it is considered to be less risky than invasive dental procedures. However, it has been pointed out that the cumulative time of bloodstream infection may pose a risk equal to or greater than that of invasive dental procedures [ 7 ]. Therefore, all patients should maintain good oral hygiene and the clinicians should counsel their patients more about this issue.…”