Dentists write more than 10% of all outpatient antibiotic prescriptions in the USA

Prescriptions in medicine are falling, in dentistry they stand still

The Council on Scientific Affairs of the American Dental Association published a commentary in JADA that holds an uncomfortable mirror up to the profession. Antimicrobial resistance is described as a global public health threat associated with increased mortality and substantial health care costs — and dentistry has long since stopped being a bystander in that picture.

National data show that antibiotic prescribing by physicians continues to fall. Among dentists, however, it remained practically unchanged from 2012 to 2022. The consequence is arithmetic: dentists today sign more than 10% of all outpatient antibiotic prescriptions. Over the same period the amoxicillin prescribing rate rose significantly, and the increase was disproportionately larger among specialists — particularly oral and maxillofacial surgeons, partly because of a broader scope of work and more complex surgical procedures.

The message of the commentary is not that antibiotics in dentistry are superfluous, but that a profession standing still while the rest of medicine moves takes on an ever larger share of responsibility for the problem — without having changed anything in its own practice.

Limitations

This is a professional commentary rather than new research, and all the data cited concern the United States; Croatian prescribing patterns may differ and call for measurement of their own.

For your practice

• Check your own pattern: how many of your prescriptions were issued for conditions resolved by drainage, trephination or extraction rather than by a drug.
• Amoxicillin "just in case" before a procedure is the easiest place to cut — the indications for prophylaxis are narrow and worth knowing by heart.
• If your practice has no written antibiotic policy, one sheet with indications and doses is worth more than any general discussion of resistance.