Antibiotic use and antibiotic resistance in dental practice

Abstract

Antibiotic resistance in bacteria is an increasing problem in health care settings worldwide. After approximately 70 years of antibiotic use, the bacteria have developed mechanisms that let them survive antibiotic treatment. The use of antibiotics is an important factor in resistance development. Norwegian dentists prescribe approximately 5.3% of the total antibiotics consumed in the country. Dentists tend to use mostly β-Lactam antibiotics, metronidazoles, macrolides, lincosamides and tetracylines. Bacteria can develop resistance to all kinds of antibiotics, by acquiring genetic traits that confer resistance to antibiotics. Horizontal gene transfer is the most effective way for bacteria to acquire new genes. Several genes are known to code for resistance against several antibiotics. Many of these genes can be found in bacteria residing in the oral cavity. To ensure rational antibiotic prescribing practices, national guidelines for antibiotic use are developed in several countries. The Norwegian ones mention two main indications for the use of these drugs in dental practice. These are specified cases of acute odontogenic infections and in some forms of periodontitis. The United Kingdom also has guidelines for prescribing antibiotic in dental practice, but these contain some differences which are highlighted in this review. The aim of this paper is to summarize and organize information about antibiotic use and antibiotic resistance to better understand the topic and the challenging situation the global society faces today; with a special focus on dental practice. An account to simplify and explain important terms used in the field of microbiology, essential to understand antibiotic resistance, are attempted. The information is mostly gathered from relevant articles published at PubMed, mainly consisting of recent publications from the last ten years. Other sources used in the current paper are published theses and internet resources from reliable organizations, such as WHO and the Norwegian FHI.