Dentists forced to prescribe unnecessary antibiotics for toothache amid pandemic

COVID-19 restrictions preventing dentists in England from providing face-to-face treatment have left some unnecessarily prescribing antibiotics for tooth pain, a study by researchers at the University of Manchester has shown.

The study findings were based on an analysis of NHS dental antibiotic prescribing data in England before and during the pandemic, and an online survey in 2021 of 159 NHS dentists across England.

The article is published in the journal British Dental today (28 October) ahead of World Antimicrobial Awareness Week (18-24 November) which aims to tackle the global emergency of antibiotic resistance.

Lead author Dr Wendy Thompson, a practicing NHS dentist and clinical researcher at the University of Manchester, said: ‘We show that Covid-19 restrictions have caused widespread frustration among dentists who know that procedures rather than prescriptions are usually the safest and fastest solution to toothache.

“Although dental infections can be dangerous, most toothaches are not caused by an infection and are therefore not relieved at all by antibiotics. Even small infections are better treated without antibiotics.

When a lack of high-quality PPE masks initially forced dental practices to close, NHS officials told dentists to carry out diagnosis and management remotely over the phone.

It was only rarely that dentists could refer patients to specially established Emergency Dental Centers (UDCs) for convenient treatment.

Half of dentists surveyed across all regions of England reported that, during the first phase of COVID-19 restrictions from March to June 2020, their referrals to a UDC were rejected because the patient had not first taken antibiotics.

A dentist told the research team:I lied a lot. When patients had pulpitis [toothache caused by inflammation not infection], I told them to say that I had prescribed antibiotics to be seen at the Hub. An antibiotic would not have been appropriate.

Another said: “Patients were refused to be seen at an emergency dental center for treatment until they received antibiotics.