Antibiotics in dental practice: Global implications, clinical realities and the path towards stewardship

Antibiotics play a crucial role in managing odontogenic infections, but inappropriate prescribing within dental practice still contributes to growing antimicrobial resistance. This review describes current U.S. recommendations from the Centers for Disease Control and Prevention (CDC), the American Dental Association (ADA), the American Heart Association (AHA) and the American Academy of Pediatric Dentistry (AAPD). Research supports using narrow-spectrum antibiotics for short treatment periods, while prophylactic use is now mainly reserved for patients with certain cardiac or immunocompromising conditions. Ongoing over prescription is often linked to uncertainty in diagnosis, patient pressure and limited stewardship systems. Thus, the need for more practical strategies like expanding education, clinical decision tools and interprofessional collaboration to strengthen antibiotic stewardship.