Dentists prescribing too many antibiotics, says BCCDC

A new poster campaign launched by the B.C. Centre for Disease Control and the B.C. Dental Association is asking people to consider how they use antibiotics, especially when they see their dentists.

B.C. Dental Association says increasingly complex work could be why antibiotics are overprescribed

While antibiotic prescribing by doctors is dropping, the opposite is true in the field of dentistry. (Getty Images)

The B.C. Centre for Disease Control says dentists are prescribing too many antibiotics — and it wants patients to help solve that problem.

A new poster campaign launched  by the BCCDC and the B.C. Dental Association is asking people to consider how they use antibiotics.

The posters, posted prominently on SkyTrains, picture the open mouth of a dental patient with the caption, "Just say 'nahhh' to antibiotics."

"Whether your patient leaves your office pissed off or happy with your decision not to prescribe, that's going to affect your likelihood to do that again," David Patrick, the centre's medical epidemiologist and lead for antimicrobial resistance, told On The Coast host Gloria Macarenko.

"That's very clear in all the behavioural literature."

Posters similar to this are being run on SkyTrains in Vancouver and other locations. (antibioticwise.ca)

That, Patrick says, is why patients need to be part of the effort, even though it is the dentist who writes the prescription.

Lower costs, fewer infections

Concerns that overprescribing antibiotics is leading to drug resistant infections are not new.

Reducing unnecessary antibiotic use has been a focus of professional medical bodies.

Patrick said a similar patient-focused efforts in B.C. to reduce antibiotic use by doctors has seen prescribing go down by 30 per cent over 20 years.

He said doctors in B.C. prescribe the least amount of antibiotics in Canada while the province is also seeing fewer serious infections, saving $50 to $80 million each year in antibiotic costs.

Dentists' use of antibiotics, conversely, has gone up 30 per cent in the same time frame.

Dentist education also ongoing

BCDA president Dr. Raymon Grewal is working with the BCCDC on the campaign.

He said much of the overprescribing by dentists is due to an increasing number of complicated procedures, especially when it comes to implants like tooth replacements.

Older research has advised prescribing antibiotics before and after those procedures but a growing body of literature suggests only prescribing antibiotics before.

"Some of it is patient-driven," Grewal added. "Sometimes, patients ask for antibiotics, particularly if it's a toothache or what seems to be a localized infection that has to do with a tooth.

"Historically, antibiotics would have been given but the true treatment of choice would be removal of the infection which… would be the removal of the tooth or a root canal."

Grewal said while patient education on better use of antibiotics is the goal of the poster campaign, education of dentists is also ongoing.

Listen to the full interview with David Patrick:

A new poster campaign launched by the B.C. Centre for Disease Control and the B.C. Dental Association is asking people to consider how they use antibiotics, especially when they see their dentists. 7:39

With files from CBC Radio One's On The Coast

About the Author

Liam Britten

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Liam Britten is a journalist for CBC Vancouver. You can contact him at liam.britten@cbc.ca or follow him on Twitter: @liam_britten.