Research Paper: Prescription of Antibiotics and Corticosteroids Following Endodontic Procedures: Study of General Dentists in Qazvin, Iran (original) (raw)
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Saudi medical journal
Introduction: Surgical and non-surgical endodontic treatment of involved teeth can necessitate prescription of analgesics and antimicrobials. The literature suggests confusion amongst practitioners regarding the need for adjunctive medication, mainly during non-surgical endodontic treatment, often leading to over-prescription. Aim: The aim of this study was to determine the current clinical practice of dentists participated in this study with respect to antibiotic and analgesic prescription patterns in their endodontic treatment management in Kuwait. Materials and Methods: Prescription patterns for antibiotics and analgesics were analyzed based on the responses to self-administered questionnaire (n = 169). Information was collected based on different clinical endodontic diagnostic scenarios. Statistical analysis was performed with SPSS software version 17.0 to determine relationships between prescription patterns, age, gender, and dental qualification (specialists and general dentists). Results: Ninety-two percent of dentists prescribed analgesics for the management of endodontic pain. While 16% prescribed antibiotics for severe dental pain; 62% prescribed antibiotics for acute apical abscesses. Significantly more male dentists prescribed antibiotics for dental pain than female dentists. No significant difference was found between general dental practitioners' and specialists' attitude toward drug prescriptions. Amoxicillin and ibuprofen were the most commonly prescribed medications. Conclusion: While the majority of dentists appeared to prescribe antibiotics and analgesics appropriately, some did not. This research confirmed previous studies and established a need for imparting information of evidence-based prescriptions protocols for the dentists surveyed in this study in Kuwait.
Application of corticosteroids in dentistry
Acta stomatologica Naissi, 2018
Introduction: Corticosteroids (CS) are natural or synthetic hormones that affect nearly every aspect of human physiology. In the clinical sense, by reducing the symptoms of inflammation and immunosuppression, CS act symptomatically, decreasing problems of the underlying disease or the current state of the patient. According to application, corticosteroids are divided into topical, local and systemic way of use. Topical use of CS makes vasoconstriction, lowers mast cells degranulation, and reduces the permeability of capillaries reducing the amounts of released histamine from basophils and mast cells. The main goal of this therapy is to relieve or at least reduce pain in patients, which has an impact on overall health, nutrition, speech. Soft tissue inflammations that require the application of CS are: recurrent aphthous stomatitis, oral submucosal fibrosis, keloids and hypertrophic scars, mucocele; painful syndrome with manifestations in the head and neck: Bechet syndrome, pemfigoid syndrome, bullous pemfigoid,Oral Lichen planus, etc.; that reduces the need for taking analgetics .In oral surgery they are used for the treatment of the impacted wisdom teeth and other serious interventions which apart from analgesics (NSAIDS and narcotic analgesics) require CS in order to reduce trizmus, swelling and pain. There are numerous studies that suggest the time and route of the administration CS in lower impacted wisdom teeth surgery, as well as different combinations of CS with other medications in order to reduce morbidity this such an intervention. Local application of CS is indicated in this treatment of gigantocellular lesions and can replace the surgical procedures. Conclusion: Corticosteroids have wide application in dentistry in their indicational areas.
Corticosteroids: A Double-Edged Sword in Dentistry
Corticosteroids are one of the extensively used drugs in dentistry. It is regarded as a doubleedged sword. On one side it is extensively used because of its excellent anti-inflammatory and immunosuppressive properties whereas on the other side it has certain contraindications. The current manuscript gives an insight view of its diverse usages, side-effects, and contraindications in the oral and maxillofacial region.
Characteristics Associated With Opioid and Antibiotic Prescribing by Dentists
American Journal of Preventive Medicine, 2021
, 901-848-5516. Colin C. Hubbard completed the analysis and contributed to the writing. Charlesnika T. Evans assisted with the study design and analysis. Gregory S. Calip assisted with the study design and analysis, and writing. Susan Rowan assisted with the study design, critical evaluation of the results and writing. Walid F. Gellad assisted with the study design, analysis, critical evaluation of the results and writing. Allen Campbell led data acquisition and assisted with variable definitions, critical evaluation of the results, and writing. Alan E. Gross assisted with the study design, critical evaluation of the results and writing. Ronald C. Hershow assisted with the study design, critical evaluation of the results and writing. Jessina C. McGregor assisted with the study design, critical evaluation of the results and writing. Lisa K. Sharp assisted with the study design, critical evaluation of the results and writing. Katie J. Suda conceived and supervised the study, critically evaluated the results and led the writing.
Pattern of antibiotics prescription by endodontists for root canal infections in Saudi Arabia
Medical Science, 2022
Background: Antibiotic resistance is a severe worldwide health concern caused by inappropriate use of antibiotics. In most cases, pulp inflammations caused by a root canal system infection do not necessitate the administration of systemic antibiotics to assess the prescriptions' attitude of the endodontist and general dentist towards antibiotics during endodontic treatment. Methodology: Between September 2020 and October 2021, a descriptive study was conducted in Saudi Arabia. Depending on a designed questionnaire distributed to general dentists, endodontists in Al-Qassim Province. Data was gathered and entered into the "Microsoft Office excel software" (2016) for Windows program, which was then analyzed using the (SPSS) program. Results: 75.3 % of the 792 participants in the study were males, and 24.7 % were girls. 40.2 % of the study's sample was between the ages of 20 and 25, and 31.4 % was between the ages of 26 and 30. Buraydah has 37.4 %, while Al-Rass has 30.3 %. 61.6 % graduated after 2015, while 19.4 % graduated between 2010 and 2015. Amoxicillin dose prescribed for adults with no allergy was reported to be 500 mg by 66.2% of participants. Amoxicillin + clavulanic acid dose prescribed for adults with no allergy was reported 500mg by 66.3%. Conclusion: In conclusion, Saudi endodontists and dentists follow worldwide guidelines when prescription antibiotics. There were, however, instances of unsuitable prescriptions, as in the case of patients who have irreversible pulpitis, necrotic pulps with no systemic involvement, and/or sinus tracts. Antibiotics and their indications in endodontics must be better understood by endodontist and dentists.
Journal of Indian Academy of Oral Medicine and Radiology, 2011
Glucocorticosteroids are used extensively in dentistry for their anti-inflammatory and immunosuppressive effects. Most of the diseases for which steroids are used are characterized by inflammation, which appears secondary to a hypersensitivity reaction against auto components. Glucocorticoids do not interfere with the primary disease mechanisms but they are used because of their anti-inflammatory and immunosuppressive effects. It seems reasonable to profit from steroids as palliatives in acute phases of the diseases and/or as long-term suppressors of the general host defense. The article deals with the use of corticosteroids in the treatment of the various conditions and diseases affecting oral cavity.
Antibiotics play an essential role in the prevention and treatment of patients at risk of experiencing microbial disease. Increasing inappropriate use of antibiotics has helped the bacteria to armour themselves and develop " Antibiotic Resistance ". Evidences have shown that antibiotic prescribed by most health care workers is sub-optimal and erratic and that about 75% of prescriptions are of questionable therapeutic value6. A 2-page custom made questionnaire was presented to local registered general dentists. Dentists were requested to complete the form pertaining to the mode of their own prescription of antibiotics. All the filled in forms were analyzed personally. The results showed that females prescribed more antibiotics compared to males and as the number of years of clinical practice increased there was a moderation and more reasoning in the mode of antibiotic prescription. Amoxycillin is the most commonly used antibiotic irrespective of the number of years or the gender of the practicing dentist.
British Journal of Pharmaceutical Research, 2014
To assess dentist's knowledge and practice in relation antibiotic prescription and to investigate if they follow the current international guidelines. Methodology: In this cross sectional study a structured and pretested questionnaire was sent to 202 licensed dental practitioners in UAE, Iran and Jordan took place in period between December 2011 and January 2012 by e-mail and physical delivery. Results: Of 160 responding dentists 93.1% would prescribe antibiotics for dentofacial infections with systemic signs but many prescribe antibiotics for conditions where antibiotic therapy is not required according to good practice. Amoxicillin was the most frequently prescribed antibiotics. The non-clinical factor that may affect decision of the majority of dentists to prescribe antibiotics was perception of the effectiveness of those antibiotics in previous cases they treated with same agent (61.25%). Most of the respondents (84%) prescribe prophylactic antibiotics for patients at risk of infective endocarditis. Conclusion: This study reveals that antibiotics were still being prescribed by dental practitioners where recent guidelines suggest there is no indication.
Advances in Medical Education and Practice
Background: Antibiotics are widely used in dental practice, especially for endodontic infections. The present survey aimed to investigate the knowledge and practices of dental interns in Saudi Arabia regarding antibiotic prescription for endodontic treatment. Methods: The present online questionnaire-based, cross-sectional study involved dental interns in private and public dental schools, Saudi Arabia. A pre-validated questionnaire was distributed to 900 dental interns via different social media platforms. The questionnaire consisted of 16 close-ended questions related to participants' demographic data and knowledge and practices of antibiotic prescription in context of endodontic treatments. Data were managed and analyzed using IBM-SPSS version 25, and Chisquare test was used to compare between the groups. Results: A total of 555 dental interns completed the questionnaire, giving a response rate of 61.1%. Overall, the surveyed participants revealed inadequate knowledge and unnecessary use of antibiotics during endodontic procedures. While majority of the participants (75.3%) correctly identified the first choice of antibiotics during endodontic treatments, a considerable proportion of the participants did not recognize the clinical indications of antibiotics in endodontic patients. Additionally, around one-fifth (18.9%) of the participants were unaware of the potential side effects of the prescribed antibiotics. Conclusion: The present survey revealed unsatisfactory knowledge and practices of antibiotic prescription in context of endodontic therapy among Saudi dental interns. Therefore, dental schools in Saudi Arabia should address such a gap through updating the curriculum and integrating real-world clinical scenarios using problem-based learning. Additionally, periodic continuous education courses aiming at improving dental professionals' knowledge about antibiotics and their clinical uses for endodontic therapy are highly encouraged.