More than half of the patients in the United Kingdom who visited their general practitioner (GP) for a dental problem instead of their dentist got a prescription for antibiotics, not long-term pain treatment, according to the Cardiff and Vale University Health Board. These prescriptions can be more than unhelpful, the researchers noted. They also could be harmful.
“Most dental problems cannot be comprehensively managed by a GP,” said Dr. Anwen Cope, a qualified dentist and specialty trainee in dental public health with the Cardiff and Vale University Health Board and one of the researchers. “This places an additional burden on already busy GPs when patients should be visiting a dentist.”
All prescriptions carry the risk of adverse reactions and could increase the number of medical consultations necessary for dental conditions later in treatment, the researchers said. But perhaps more importantly, these patients may develop antibiotic drug resistance, making later treatments that may be necessary less effective.
“Antibiotics save lives, and therefore it’s important we use them carefully and only when they are really required,” said Cope. “Improving antibiotic prescribing for dental problems is an important step in ensuring antibiotics will still be available in the years to come.”
The study examined 288,169 dental consultations among general practices in the United Kingdom from 2004 to 2013, with 57.1% of them resulting in an antibiotic prescription. While it didn’t identify why patients went to a GP instead of a dentist, the researchers noted that prescriptions alone would not solve underlying dental issues and could leave the patient in pain for longer than necessary.
“The best treatment for severe toothache remains an operative intervention like an extraction or root canal treatment,” said Cope. “These treatments can only be undertaken by a dentist. Therefore, we would always encourage patients to see a dentist, rather than a GP, when experiencing dental problems.”
The researchers speculated that these patients might be going to a GP because of an inability to get a timely appointment with a dentist. Still, the researchers hope their study will promote more appropriate consulting for dental problems and a reduction in antibiotic prescriptions by GPs for patients with dental problems.
“GPs should avoid routinely prescribing antibiotics when patients present with dental problems, and more work is needed to identify how patients experiencing dental problems can best be directed to emergency dental services,” Cope said.
The study, “Dental Consultations in UK General Practice and Antibiotic Prescribing Rates: A Retrospective Cohort Study,” was written by Cope with Ivor G. Chestnutt, Fiona Wood, and Nick A. Francis and published by the British Journal of General Practice.