The results of a national study raise significant red flags concerning antibiotic prescribing practices in the dental setting.

Researchers examined nearly 170,000 dental visits from 2011-2015 that included the prescribing of antibiotics to prevent infections before the visits. When evaluating practices against current American Dental Association (ADA) and American Heart Association (AHA) guidelines, researchers found that antibiotics were prescribed unnecessarily for about 80% of the visits. Of those, nearly 4% were associated with an adverse event within two weeks, including nearly 4,000 allergic reactions, about 1,600 emergency room visits and several Clostridioides difficile (C. diff) infections.

As a press release about the study notes, antibiotics are often prescribed before dental visits to help prevent infections in certain patients, such as those who have undergone joint replacements. However, current ADA and AHA guidelines no longer recommend this use of antibiotics in most cases. 

In the release, Dr. lan Gross, clinical associate professor at the University of Illinois at Chicago College of Pharmacy and a co-author, is quoted as saying, "While antibiotics can be lifesaving, they can cause significant adverse events even after being taken for only a day or two. Also, misuse can lead to antibiotic resistance. Antibiotics should only be prescribed when necessary and people should talk with their dentist or physician to ask if they truly need antibiotics prior to a dental visit."

The study was recently presented at IDWeek 2019, the annual meeting of the Infectious Diseases Society of America (IDSA), the Society for Healthcare Epidemiology of America (SHEA), the HIV Medicine Association (HIVMA) and the Pediatric Infectious Diseases Society (PIDS).