Study aims to reduce antibiotic overuse in dentistry

Dental Tribune International

Tue. 1 July 2025

save

LEEDS, England: While antibiotics remain essential for treating infectious diseases, their global efficacy is declining owing to the rise of antimicrobial resistance (AMR). In response to this growing concern, researchers from the University of Leeds and the Bharath Institute of Higher Education and Research in Chennai have launched a pilot community engagement study aimed at addressing the overprescription of antibiotics in dental care.

Research indicates that AMR could directly result in 11.8 million deaths between 2025 and 2050 in South Asia alone. The inappropriate prescription of antibiotics for conditions such as dental pain has been identified as a significant contributing factor.

Dr Vishal Aggarwal, clinical associate professor in acute dental care and chronic pain at the University of Leeds School of Dentistry, decided to investigate the issue after volunteering in rural South India. He told Dental Tribune International: “I volunteered at a dental clinic in a remote village in South India between 2007 and 2009, working in two-week blocks, and witnessed first-hand the indiscriminate use of antibiotics when they were not needed—for example, antibiotics given to all patients following simple dental extractions. This led me to investigate the scale of the problem.”

As part of the pilot study, Dr Aarthi Bhuvaraghan, a research scholar at the University of Leeds, recruited local dental practitioners who received a desk guide and participated in a continuing professional development (CPD) module. Following the intervention, participants demonstrated improved knowledge and a readiness to adopt changes in approaches to prescribing treatments.

“Dentists tried not to prescribe after extracting teeth, and some reported they were surprised that patients did not develop infections,” Dr Aggarwal noted. “They were willing to prescribe analgesics instead of antibiotics.”

Reflecting on her experience, Dr Bhuvaraghan said in a press release: “Having practised in the UK and India, I realised this is a big problem and nothing was being done about it. It is difficult to blame the dental practitioners because they are not aware of the damage being done, but we are positive there can be a shift in behaviour.”

The CPD module is currently being digitalised and will soon be made freely accessible via the Indian Dental Association’s website. There are also plans to integrate the programme into undergraduate education.

Shifting prescribing norms

Prescribing practices in India differ significantly from those in the UK, influenced by cultural and systemic factors. Dr Aggarwal explained that antibiotics are often prescribed in India after dental extractions or for dental pain—even when not clinically necessary. “Patients may go elsewhere if not given antibiotics,” he said, pointing to patient expectations, time constraints, financial considerations and concerns about losing patients’ trust as key drivers.

Prof. Bhuminathan Swamikannu, registrar at the Bharath Institute of Higher Education and Research, underlined the wider impact of the initiative. He said in a press release: “As a dental practitioner, I have witnessed first-hand how the risks of antimicrobial resistance are often underestimated, and how the important role dentists play in addressing this issue is frequently overlooked.”

“We are positive there can be a shift in behaviour.”—Dr Vishal Aggarwal, University of Leeds

He continued: “Dr Aarthi Bhuvaraghan’s research has clearly highlighted the extent of antibiotic misuse in India and the lack of national or local policies to guide dental practice. More importantly, her work has had a profound impact in raising awareness and educating dental professionals and thereby enhancing clinical practice and promoting patient safety. With her support, we are now working to integrate antimicrobial stewardship into the undergraduate dental curriculum.”

Looking ahead, the research team hopes to expand the programme across India and beyond. Dr Aggarwal noted that a larger clinical trial would be necessary to evaluate the impact of the intervention on antibiotic prescribing patterns. “Once the programme has been digitised and incorporated into the undergraduate curriculum, it will be made available online to improve knowledge on appropriate antibiotic prescribing in dentistry,” he noted and added that a randomised controlled trial would be needed to evaluate whether the programme leads to sustained behavioural change.

“Dentists need to consider dental procedures—such as tooth extraction or pulp removal—over antibiotic prescriptions as first-line treatment for managing dental pain and infection,” Dr Aggarwal noted. “Remember the mantra: Procedures, not prescriptions,” he concluded.