IADR Abstract Archives
Are Dental Providers Adhering to Antibiotic and Analgesic Prescription Guidelines?
Objectives: There is often a lag between evidence-based clinical guidelines and clinical practice. In recent years, the ADA released updated antibiotic prophylaxis and opioid prescribing guidelines. The objective of this study was to examine the prescribing patterns of university-based dental providers following tooth extractions as they compare to the ADA guidelines.
Methods: We conducted a cross-sectional study of providers at a US academic institution using data from the BigMouth Dental Data Repository. A retrospective chart review was performed on the electronic health records of patients (n=45) who met our inclusion criteria (received an examination CDT code or medication within 7 days of tooth extractions). Descriptive statistics and bivariate analyses were produced using STATA v15.
Results: Overall, the sample had a higher proportion of females (64.4%), Caucasians (28.9%), and a mean age of 47.7 ± 24. Most patients were classified as low or middle income, and Medi-Cal enrollees. Of the 123 tooth extractions, the majority (88.9%) were non-surgical, and involved
molar teeth (40%). Almost half of all patients underwent multiple extractions and the most common indication for extraction was periodontal disease. Approximately 10% of patients received prophylactic antibiotic prescriptions. Post-operatively, only 17.8% of patients received
post-treatment analgesic prescriptions (of which 50% were opioids), and over one-quarter (26.7%) received antibiotic prescriptions. Post-operative complications occurred in 22.2% of patients; however, all were classified as temporary or mild harm. Bivariate analyses revealed no
significant associations between procedure type, provider type, or medical co-morbidities, and analgesic and antibiotic prescribing patterns.
Conclusions: Our study revealed that a significant proportion of patients still received opioid prescriptions when they require post-treatment analgesic medications, despite several studies highlighting its sub-optimal efficacy as the first line treatment following tooth extractions. Similarly, dental
patients routinely received antibiotic prophylaxis when not medically indicated, and posttreatment antibiotics following surgical extractions.
Methods: We conducted a cross-sectional study of providers at a US academic institution using data from the BigMouth Dental Data Repository. A retrospective chart review was performed on the electronic health records of patients (n=45) who met our inclusion criteria (received an examination CDT code or medication within 7 days of tooth extractions). Descriptive statistics and bivariate analyses were produced using STATA v15.
Results: Overall, the sample had a higher proportion of females (64.4%), Caucasians (28.9%), and a mean age of 47.7 ± 24. Most patients were classified as low or middle income, and Medi-Cal enrollees. Of the 123 tooth extractions, the majority (88.9%) were non-surgical, and involved
molar teeth (40%). Almost half of all patients underwent multiple extractions and the most common indication for extraction was periodontal disease. Approximately 10% of patients received prophylactic antibiotic prescriptions. Post-operatively, only 17.8% of patients received
post-treatment analgesic prescriptions (of which 50% were opioids), and over one-quarter (26.7%) received antibiotic prescriptions. Post-operative complications occurred in 22.2% of patients; however, all were classified as temporary or mild harm. Bivariate analyses revealed no
significant associations between procedure type, provider type, or medical co-morbidities, and analgesic and antibiotic prescribing patterns.
Conclusions: Our study revealed that a significant proportion of patients still received opioid prescriptions when they require post-treatment analgesic medications, despite several studies highlighting its sub-optimal efficacy as the first line treatment following tooth extractions. Similarly, dental
patients routinely received antibiotic prophylaxis when not medically indicated, and posttreatment antibiotics following surgical extractions.