Understanding antimicrobial resistance (AMR) and the drivers for its development will help healthcare professionals work together to reduce its emergence and spread. It is well documented that the more we use antimicrobial agents, the more drug resistance will develop. Fourteen national dental organisations have come together to support the World AMR Awareness Week theme, “Preventing Antimicrobial Resistance Together”.

If no action is taken, AMR infections are predicted to lead to 10 million deaths annually by 2050; a number higher than the total caused by COVID-19 during the pandemic period. Therefore, dental professionals have worked together to update the online dental antimicrobial stewardship (AMS) toolkit with resources for dental teams, students and patients as well as wider healthcare professionals.1 The range of educational resources included a new website for students and educators providing links to various online training courses.2  

Our profession already focuses on the prevention of oral diseases to reduce the incidence of severe infections that necessitate the use of antimicrobial agents. Adhering to the best practice recommendations aimed at preventing infections, in addition to stewarding the use of antimicrobial agents, is very important. Accordingly, “Delivering better oral health: an evidence-based toolkit for prevention3” is included in the updated AMS toolkit1. It is also acknowledged that system-level changes are required to facilitate the provision of best practice. Furthermore, we need to look to the future and ensure appropriate disposal of antimicrobials to reduce environmental contamination.  Guidance on the appropriate disposal of waste in healthcare settings including dentistry is available in HTM07-01 and SHTN3.4

We encourage you to make the most out of these resources to ensure you and your team are working together to help keep your patients safe by tackling the problem of AMR:

  1. Dental Antimicrobial Stewardship Toolkit* is available via https://www.gov.uk/guidance/dental-antimicrobial-stewardship-toolkit
  2. Keep Antimicrobial Working (KAW) education resource for students and educator are available at https://bsac-kaw.co.uk/
  3. Delivering better oral health: an evidence-based toolkit for prevention is available via https://www.gov.uk/government/publications/delivering-better-oral-health-an-evidence-based-toolkit-for-prevention
  4. Safe and sustainable management of healthcare waste is available via https://www.england.nhs.uk/wp-content/uploads/2021/05/B2159iii-health-technical-memorandum-07-01.pdf and for Scotland, the Scottish Health Technical Note 3 (SHTN 3) in https://www.nss.nhs.scot/publications/waste-management-shtn-3/
  5. Dental Antimicrobial Stewardship in Scotland is available via https://www.sapg.scot/guidance-qi-tools/dental-stewardship/. SAPG Dental statement  recommending phenoxymethylpenicillin as first line when antibiotics are required for acute dento-alveolar infections available via https://www.sapg.scot/media/5473/statement-on-pen-v-in-dental-infections.pdf

This statement is developed and supported by the Association of Clinical Oral Microbiologists, College of General Dentistry, Association of Dental Hospitals, British Association of Oral Surgeons, British Association for the Study of Community Dentistry, British Dental Association, British and Irish Society of Oral Medicine, British Society of Antimicrobial Chemotherapy, Faculty of Dental Surgery of the Royal College of Surgeons of England, Faculty of Dental Surgery of the Royal College of Physicians and Surgeons of Glasgow, Faculty of Dental Surgery of the Royal College of Surgeons of Edinburgh, Faculty of Dentistry of the Royal College of Surgeons in Ireland, Scottish Antimicrobial Prescribing Group and Health Education and Improvement Wales.

*Recent updates to the Dental Antimicrobial Stewardship Toolkit are in the process of being made online. If signposted to the former FGDP, users should instead visit https://cgdent.uk/standards-guidance/

Published by College of General Dentistry