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    The dangers of microbial resistance in the dental practice

    With many dentists overprescribing antibiotics, microbial resistance is becoming a big concern in the dental industry.

    In 1902, English author W.W. Jacobs published the short story “The Monkey’s Paw.” In it, the protagonists are gifted a mummified monkey’s paw, said to bestow three wishes – which it certainly does. Regrettably, each wish is granted with a macabre twist.

    Antibiotics — the 20th century’s miracle drug — was discovered two decades after “The Monkey’s Paw” was published, and it has , itself, become a real-world manifestation of Mr. Jacobs’s literary masterpiece. There’s no denying that antibiotics have saved millions, if not billions, of lives. However, we’ve learned that they also come with strings attached.

    The lowdown

    “Antibiotics were the wonder discovery of the 20th century,” says Dr. Marie Fluent, DDS, an educational consultant for The Organization for Safety, Asepsis and Prevention (OSAP). “Alexander Fleming discovered penicillin in 1928, and it really was not widely used until the1940s, but bacterial resistance quickly developed. Shortly thereafter, adverse events — and sometimes life-threatening events — were associated with the use of antibiotics. According to the CDC, there are currently at least 2,049,000 antibiotic resistance infections per year, and about 23,000 deaths directly associated with antibiotic resistance per year. This costs the United States about $30 billion annually.”

    Trending article: The dental prescriptions that are killing your patients

    While microbial resistance is a problem that most commonly affects medical professionals, there are also issues specific to the dental community.

    Dr. Fluent observes:

    • Dentists write approximately 10 percent of all antibiotic prescriptions for humans.
    • Dental personnel may receive pressure from patients and other clinicians to write antibiotic prescriptions.
    • There’s difficulty collecting data on whether or not the prescriptions written in dentistry are appropriate.
    • Dental students receive limited education on antibiotics.
    • While there are specific guidelines for antibiotic prophylaxis, there are limited guidelines for prescribing antibiotics in dentistry for the treatment of infections.
    • There’s concern that there are unnecessary and inappropriate prescribing practices of antibiotics in dentistry.

    Antibiotics“Overprescribing antibiotics has been prevalent in the medical and dental profession for over four decades and, as a result, that over prescription of antibiotics has selected out antibiotic-resistant microorganisms because they are the ones that are surviving,” says Jackie Dorst, RDH, BS, an infection prevention consultant and speaker. “So we’re seeing more and more of these antibiotic-resistant microorganisms because of antibiotics’ overuse.

    “We all know that you have to recolonize by taking a probiotic or eating yogurt after you’ve taken a regimen of antibiotics,” Dorst continues. “Now the ones that are resistant are being selected out. They may stay on a surface or be on our bodies and not causing infection until there’s an opportunity; until there is a weakness in the immune system; until there’s a break in the skin that they’re introduced, and then that’s where they have the opportunity to multiply, thrive and go on to cause a serious infection. But the physicians have nothing to treat the patient with because those microorganisms are resistant to all of the antibiotics that are currently available.”

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    Robert Elsenpeter
    Robert Elsenpeter is a freelance writer and frequent contributor to Dental Products Report and Digital Esthetics. He is also the author ...


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