The role of dental professionals in the fight against Antibiotic Resistance - Professor Machtei

The use of antibiotics in the treatment of periodontal pocketing ?5mm exposes patients to the unnecessary risk of antibiotic resistance.

The global threat of Antimicrobial Resistance (AMR) continues to grow today, as more new strains of resistant pathogens are continuously found. Though ‘superbugs’ such as MRSA and C. difficile have seen some decline thanks to stringent control systems in the healthcare setting, newer threats such as MSSA and multi-drug resistant E. coli and N. gonorrhoeae continue to emerge.[i]

In the Chief Medical Officer’s Annual Report published in 2013, it was stated that evidence clearly links the widespread use of antibiotics to the selection of resistant organisms.[ii]

The fight against AMR needs to be a consolidated, global effort, as the UK Five Year Antimicrobial Resistance Strategy published in 2013 recognises. As prescribers of antibiotics, dental care professionals have a major role to play in the implementation of the strategy’s main points of action:

• Improve the knowledge and understanding of AMR
• Conserve and steward the effectiveness of existing treatments

Improving the knowledge and understanding of AMR is important for both professionals and patients alike. Wide-reaching awareness movements such as the annual European Union Antibiotic Awareness Day helps spread AMR awareness among the public and can consequently curb the habit of automatically requesting antibiotics with no clinical indication.

Conserving and stewarding the effectiveness of existing treatments is also a shared responsibility that involves correct diagnosis, proper prescription and patient understanding and compliance.

There are several ways in which dental care professionals can cut down on the prescription of antibiotics. For example, an FGDP press release sent out last November 2013 reminded dental practitioners that the majority of uncomplicated dental swellings can be resolved by drainage of the associated abscess, and that dental surgical skills should always be considered before defaulting to antibiotic prescription.

Another example in which routine antibiotic prescription can be cut down is in the treatment of periodontitis. Most dentists and dental hygienists will automatically prescribe metronidazole or amoxicillin as adjuncts to scaling and root planing (SRP) in the treatment of advanced gum disease. But in light of the grave threats of AMR it may be time for other therapies to be considered.

Dental care professionals who are looking for effective non-antibiotic adjuncts to periodontal treatment can turn to effective alternatives such as PerioChip®, a small, rounded device indicated for insertion in periodontal pockets that are at least 5mm deep.

There is no alternative product in the market that can match the high local concentrations of chlorhexidine that PerioChip® delivers. The broad-spectrum antiseptic in this formulation is clinically effective at eliminating 99% of subgingival periopathogenic bacteria without the risk of antibiotic resistance.

Dental care professionals have an important role to play in the fight against AMR. By looking to their clinical skills and considering antibiotics only when absolutely necessary, the overuse of the drugs can slowly be stopped, and AMR arrested in its rapid and alarming development.

For more information or to contact the team behind PerioChip®, email This email address is being protected from spambots. You need JavaScript enabled to view it. or call 0800 013 2333

Professor  Machtei is currently the head of the Rambam HCC School of graduate dentistry and chairman of the department of Periodontology