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Can we reduce antibiotic prescribing in dentistry?

Blog Author Susie Sanderson

Blog Date 02/05/2019

 

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A recent event – organised by the All-Party Parliamentary Group for Dentistry and Oral Health to which the BDA provides secretariat, and co-hosted by the APPGs on Pharmacy and Antibiotics – gave members of Parliament and Peers a chance to question a panel of experts in antimicrobial resistance across the main fields of primary care; in dentistry, pharmacy and general medical practice, and to discuss how we can reduce antibiotic prescribing in dentistry.

 

​Antimicrobial resistance is arguably the gravest threat to public health both here in the UK and worldwide. 25,000 people die each year in Europe from sepsis caused by antibiotic resistant bacteria and failure to tackle this growing problem could lead to many routine medical interventions becoming life-threatening in the decades to come.

 

Facing up to the danger presented by antibiotic resistance will require urgent and coordinated action between policymakers, healthcare professionals and other stakeholders. So, I was delighted to get this opportunity to address MPs and Lords at an oral evidence session in Parliament this week on what has and needs to be done in dentistry to reduce antibiotic prescribing. 

 

It was great to see this event so well attended by Parliamentarians, with attendees including a Shadow Health Minister and a former Secretary of State for Health – a sign, I hope, that this issue is finally getting the cut-through it deserves on the political arena.


My fellow panellists and I agreed that it was crucial there was consistency of messaging across the health service on this issue, and the need to educate patients on when antibiotics are needed and the dangers of their inappropriate or unnecessary use.

 

As dentists, we need support from politicians and other health professionals in spreading the message that antibiotics do not cure toothache, which almost always requires operative treatment.

 

Why is AMR an important issue for dentistry?

Dentistry can often be seen as peripheral to the antimicrobial resistance (AMR) agenda, but with close to three million courses of NHS antibiotics prescribed every year by dentists in England alone, we clearly have an important role to play.

 

The dental profession has taken the lead on reducing inappropriate prescribing – in 2014 the BDA hosted a summit on AMR in dentistry which raised the profile of this issue with the profession and other stakeholders, and led to development of an action plan and a free antibiotic prescribing self-audit tool for practices, developed with the Faculty of General Dental Practice. This tool has recently been updated and we hope it will help colleagues build on their success in reducing prescriptions.

 

As a result of this and other initiatives UK dental practices have made huge strides in reducing antibiotic prescribing – dentists dispensed around a quarter fewer prescriptions for antibiotics in 2017 compared to 2013 – but with 5.2% of all antibiotics still prescribed in dentistry, much more remains to be done.

As I explained to Parliamentarians during the event, despite the progress we've already made, a large proportion of antibiotics prescribed in dentistry could still be avoided.

 

How can we reduce antibiotic prescribing rates in dentistry?

To achieve further reductions in prescription rates, however, dentists do need the time and the confidence to do the right thing.

 

I reiterated our long-standing call for the Government to commission appropriately funded urgent-care slots, which would allow colleagues to provide appropriate interventive treatment when required, rather than prescribe antibiotics unnecessarily.

As fewer dental problems would mean less need to use antibiotics, I also stressed the need for more investment in oral health prevention measures such as supervised tooth-brushing in schools and early years settings, fluoride varnish applications and stronger action on sugar.

 

Finally, I urged policymakers to act to reduce waiting lists for child hospital tooth extractions. Currently children in many parts of the country face waits of anything up to a year to have their badly decayed and infected teeth removed – that means it's not atypical that they receive 2 or 3 courses of antibiotics during that time. We all know that giving repeated courses of amoxicillin to small children to help treat a completely preventable disease is the most inappropriate thing that we could possibly be doing. 

I was privileged to speak for the profession at this event and make some noise about a topic which is very dear to my heart.

 

The three APPGs will now detail the recommendations put forward by myself and my fellow panellists at the session in a joint report, which will be presented to the Secretary of State for Health, the Department for Health and Social Care and all other key stakeholders.

 

I hope it will help build momentum for action against the existential threat posed by antimicrobial resistance. 

 

Susie SandersonDr Susie Sanderson

BDA Health and Science Committee

Leader of the Task Force on Antibiotics in Dentistry, Council of European Dentists

BDA Past President

 

@susie_sanderson

 

 

 

 

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