Bacterial Resistance and Dental Practice: Our Role and Responsability

Objective.- To provide a practical advice for dental professionals to combat and prevent the bacterial resistance in the clinical practices. Methods.- An electronic database was constructed using the digital repositories publications PubMed and Sciencedirect, with a combination of Medical Heading Subject (MeSH) of “antimicrobial agents” “bacterial resistance” “dental practice role” and “prevention”. The Medline was performed (2000-June 2010) with emphasis in systematic reviews, randomized controlled trials and cohort studies. The conclusions were classified and prioritized according to the type of study and presented as a set of clinical measures for halt de bacterial resistances in dental practice. Results.- Antibiotic use over time has led to emergence of infectious bacteria that are resistance to several antibiotics. Bacterial resistance is now considered a major threat to public health, and control of resistance is an international priority. The Dentist treats a large number of infections that no need antibiotics; therefore is possible decrease the selective pressure over the sensible strains in dental infections by reducing in the prescriptions of antimicrobial drugs. Likewise; an appropriated diagnosis, dose and duration of the therapy can lead to halt selective pressure that increase the incidence of resistance. Another clinical measure is the antibiotic cycling (rotation) each 90 days for decrease the selective pressure that kill the sensible strains helping the proliferation and virulence of the resistant bacteria. Conclusions.- The bacterial resistance is a global problem that can take to the population to a epidemiologic standards of the 19° century. The dental and the vet professional play an important role in the emergence of this problem All antibiotics allows survive resistant strains even in therapeutic doses. Less antibiotics prescriptions reduce the incidence of resistance. Infections control and adequate use of antibiotics contribute to halt the bacterial resistance. Antibiotic cycling each 90 days is recommended.