In an open letter to Health Secretary Wes Streeting, dentists have warned that a failure to fully meet demand for urgent dental care can only increase the pressures on our health service, as antibiotics become a substitute for treatment.
The unmet need for dental appointments is high
The chances of a dental appointment resulting in an antibiotic prescription increased dramatically during the pandemic, and new research led by Dr Wendy Thompson from The University of Manchester, published today, shows prescribing levels across each of the UK’s four nations have been slow to return to where they would have been if the pandemic hadn’t happened.
Though the Government has begun commissioning 700,000 urgent appointments, the British Dental Association says the total unmet need is far higher.
Patients need access to urgent dental care, not just antibiotics
Dr Thompson also leads on antimicrobial stewardship for the College of General Dentistry and chairs the FDI World Dental Federation’s Preventing Antimicrobial Resistance (AMR) and Infections task team.
She said:
Too many people have been unable to access urgent dental treatment for toothache, and have ended up with antibiotics. The best way to protect us all from the existential threat of antibiotic resistance is to ensure patients have timely access to urgent care.
Even before the COVID-19 pandemic, we knew that dentistry was responsible for around 10% of antibiotic prescriptions and that rates of unnecessary use were high. During the early part of the COVID-19 pandemic, the amount of antibiotic prescribing by NHS dentists increased dramatically.
Our research has shown how frustrated dentists were at this situation which UK Health Security Agency researchers have linked to the use of teledentistry, where care is given remotely. Our latest research shows just how slowly antibiotic prescribing in NHS dentistry is returning to its pre-pandemic pattern.
Antibiotics don’t cure toothache although our research shows that many people wrongly believe they are necessary. Unnecessary use puts patients and the public at risk from the spread of infections which don’t respond to antibiotics. The quickest fix for toothache and dental infections is generally a procedure rather than a prescription, although sometimes antibiotics are vital. And our research found that appointments where dentists provide procedures take more time than just giving antibiotics.
That is why FDI World Dental Federation argues that universal access to the right oral health care at the right time to prevent and treat toothache and dental infection should be an essential part of national efforts to tackle antimicrobial resistance by reducing the unnecessary use of antibiotics.
Routine monitoring of antibiotic prescribing by dentists providing care to NHS patients is key, but until prescribing by dentists is digitised, this will be impossible. Integrating high-street dentistry into NHS digital systems will be an important part of national efforts to help keep patients safe by ensuring antibiotics are only prescribed when strictly necessary.
