Assessing behaviours in antimicrobial prescribing and implants in the UK: a pilot study

With implant dentistry growing in popularity as a means of replacing missing teeth, there is an increasing need for guidance to support regular practice and to ensure that implantology is reinforced with an appropriate evidence base for developing safe prescribing habits. This is particularly important as the prescribing of antibiotics in implant dentistry is becoming increasingly controversial owing to the fear of any failure due to post-operative infection; the possible litigation consequences that might emerge can be a major reason for justifying such prescription protocols.

A questionnaire-based pilot study was carried out, which assessed prescribing behaviours by UK-based dentists placing dental implants. The 11-item questionnaire sought information on implant procedures categorised as straightforward and complex implant procedures. The survey was distributed electronically through local implant study clubs and via dental social media forums.

A total of 54 dentists responded, with almost 89% of respondents prescribing antibiotics pre-operatively and 85% prescribing antibiotics post-operatively, with amoxicillin always the primary choice. The recommended course of treatment varied between one and seven or more days. Almost half of the respondents prescribed analgesics pre- and/or post-operatively with ibuprofen and paracetamol as the first and second choices, respectively. Dexamethasone was prescribed pre- and post-operatively by 7% of the dentists.

This study highlighted a lack of national antibiotics prescription guidelines and a lack of consistency in implant dentistry practice in the UK. It also indicated the need for multi-centre studies with large sample sizes that can support the foundation for appropriate guidelines on antibiotic prescribing in implant dentistry.