Antimicrobial Resistance in Oral Healthcare: A Growing Concern in Dentistry

One of the most significant public health issues of the twenty-first century is antimicrobial resistance (AMR), which is responsible for thousands of deaths each year and undermines the efficacy of commonly used antibiotics. In dentistry, the frequent and sometimes inappropriate use of antibiotics, combined with the complexity of the oral microbiome, creates a high-risk environment for the development and spread of antimicrobial-resistant microorganisms. Although clinical infections have received most of the attention, dental unit waterlines, dentures, and orthodontic appliances are three reservoirs that play an important but underestimated role in this global crisis. These environments provide perfect conditions for biofilm formation and, further, the survival and growth of resistant microorganisms. This review aims to discuss the origins and mechanisms of AMR, the unrecognized role of these three reservoirs in dental settings, and their contribution to the AMR issue. It also highlights the necessity of strict infection control procedures and targeted antimicrobial stewardship strategies to overcome this growing threat.