Antimicrobial Resistance in Dentistry

Antimicrobial resistance (AMR) has become a prominent challenge in modern healthcare. It occurs when bacteria evolve mechanisms that allow them to survive exposure to antibiotics that once effectively treated infections. The impact is significant because infections become harder to treat, often requiring stronger medications, longer hospital stays, or surgery (Nizami et al., 2025). While antimicrobial resistance is often associated with medical practice, dentistry also plays an important role. Dentists account for about 10% of antibiotic prescriptions worldwide (Thompson et al., 2021). As antibiotic-resistant bacteria continue to increase, dental professionals have an important responsibility to prescribe antibiotics only when clinically necessary. 

Many common dental conditions can be effectively managed with local treatment rather than antibiotics. Conditions such as irreversible pulpitis, localized dental abscesses, and symptomatic apical periodontitis are often best treated with procedures such as pulpectomy, root canal therapy, drainage, or tooth extraction. Clinical guidelines from the American Dental Association recommend against routine antibiotic use for most localized odontogenic infections in otherwise healthy patients because antibiotics alone do not eliminate the source of infection (Lockhart et al., 2019). Prescribing antibiotics when they are unnecessary contributes to bacterial resistance and exposes patients to avoidable adverse effects. 

When antibiotics are used, selecting the appropriate medication, dosage, and duration is essential. Dentists should prescribe antibiotics in line with current evidence-based guidelines and avoid unnecessary use of broad-spectrum agents. Antibiotic stewardship encourages healthcare professionals to prescribe antibiotics only when clinically indicated and to educate patients on their proper use. Stewardship programs also encourage clinicians to regularly review prescribing practices and stay up to date with evolving clinical guidelines to ensure antibiotics are used safely and effectively (Nizami et al., 2025). These practices help reduce the development of resistant bacteria and preserve the effectiveness of existing treatments. 

Antimicrobial resistance is a growing public health concern that demands collaboration across all healthcare professions, including dentistry. By adhering to evidence-based prescribing guidelines and educating patients on responsible antibiotic use, dental professionals can help preserve the effectiveness of antibiotics for future generations. Responsible prescribing not only improves patient care but also helps protect global public health (Nizami et al., 2025).

References:

Lockhart, P. B., Tampi, M. P., Abt, E., Aminoshariae, A., Durkin, M. J., Fouad, A. F., Gopal, P., Hatten, B. W., Kennedy, E., Lang, M. S., Patton, L. L., Paumier, T., Suda, K. J., Pilcher, L., Urquhart, O., O’Brien, K. K., & Carrasco-Labra, A. (2019). Evidence-based clinical practice guideline on antibiotic use for the urgent management of pulpal- and periapical-related dental pain and intraoral swelling: A report from the American Dental Association. The Journal of the American Dental Association, 150(11), 906-921.e12. https://doi.org/10.1016/j.adaj.2019.08.020

Nizami, M. Z. I., Yin, I. X., Niu, J. Y., Yu, O. Y., & Chu, C. H. (2025). Antibiotic Resistance in Dentistry: A Review. Antibiotics, 14(12), 1259. https://doi.org/10.3390/antibiotics14121259

Thompson, W., Williams, D., Pulcini, C., Sanderson, S., Calfon, P., & Verma, M. (2021). Tackling Antibiotic Resistance: Why Dentistry Matters. International Dental Journal, 71(6), 450–453. https://doi.org/10.1016/j.identj.2020.12.023