Prophylactic antibiotic prescribing in dental practice: Findings from a National Dental Practice-Based Research Network questionnaire

Background: Little is known about antibiotic prescribing practices of dentists. The objective of this study was to gain a better understanding of dentists’ beliefs and behaviors regarding the use of antibiotic prophylaxis (AP) before invasive dental procedures. Methods: A multidisciplinary team developed and disseminated a questionnaire to 3,584 dentist members of the National Dental Practice-Based Research Network. Results: Overall, 2,169 network dentists (61%) responded. Respondents saw patients at risk of developing infective endocarditis (IE) and prosthetic joint infection (PJI) at least once per week (35% and 65%, respectively). Although 78% of dentists agreed that the 2007 American Heart Association guidelines for the prevention of IE are well-defined and clear, only 49% agreed concerning PJI guidelines. Differences for the IE and PJI patient populations also existed for questions regarding dentists’ understanding of the specific patient groups at risk, the recommended antibiotic regimens, and the need to consult with a patient's cardiologist or orthopedic surgeon. Conclusions: The survey results indicate that decision making regarding the use of AP occurs frequently among dentists. Moreover, dentists reported uncertainty about the appropriate use of AP as defined by both IE and PJI guidelines, which may have resulted in a lack of concordance between dentists’ beliefs and their practice behaviors. Practical Implications: The results reported by the authors highlight the need to develop better educational programs that address antimicrobial stewardship in AP for patients at risk of developing IE and PJI and target the dental profession.