Analysis of a decade of prescribing practice within the NHS revealed concerning trends that require a reassessment of approaches to drug prescription in primary dental care. A retrospective study of NHS data in England for the period 2014–2023 showed that the prescription of antimicrobial agents and analgesics, which sharply increased during COVID-19 restrictions, overall returned to pre-crisis levels. Nevertheless, the continuing prescription of certain medications indicates the need for continuous monitoring of antimicrobial resistance, regular audits of prescribing practice, and professional development of specialists.
Over the decade, a significant reduction in the overall volume of antibiotic prescriptions was noted, which, in the opinion of the study authors, reflects the impact of antimicrobial resistance control initiatives, national guidelines, and increased awareness within the professional community of the associated risks. Amoxicillin remained the most frequently prescribed agent, with metronidazole being the second most common. This trend demonstrates that dental practitioners’ practice is consistent with the recommendations of national protocols for the treatment of odontogenic infections.
However, the temporary escalation of prescriptions during the pandemic, driven by the transition to remote patient management, revealed a critical issue: clindamycin prescription did not return to pre-pandemic levels. This raises concerns, as national guidelines recommend avoiding routine use of clindamycin due to its association with Clostridioides difficile infections and the availability of safer alternatives for most odontogenic infections. This fact demonstrates the need to strengthen educational initiatives aimed at reassessing the use of clindamycin in ambulatory dental practice.
Similar dynamics were observed in analgesic prescription. While the overall trend returned to decline by the end of 2023, the use of dihydrocodeine remained above pre-pandemic levels, accounting for more than two-fifths of all dental analgesic prescriptions in December 2023. Given the limited role of opioids in the treatment of acute dental pain and the recognized risks of dihydrocodeine—dependence, nausea, constipation—the authors emphasize the need to reconsider its use. This problem is particularly relevant in the context of global concern about opioid dependence and requires adjustment of prescribing practice in primary dental care.
The study, published in British Dental Journal, confirms the effectiveness of national antimicrobial resistance control programs in sustaining the reduction of unjustified drug prescriptions. The authors conclude that continuous professional education, regular audits of prescriptions, and strict adherence to national standards are necessary, with particular emphasis on limiting the use of clindamycin and dihydrocodeine. These recommendations should be integrated into programs for the retraining of dentists and serve as the basis for the development of local prescribing protocols in primary dental care organizations.
At a press briefing held as part of the International Symposium on Dental Hygiene (ISDH) in Milan, experts discussed two
Japanese researchers conducted a controlled study that revealed an interesting pattern: special lozenges containing a postbiotic based on inactivated bacteria
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