Suspension of Certain Dental Procedures Due to COVID-19: A Source of Over-Prescription?

Dentists have always been attributed to the ever rising global problem of antibiotic resistance. The recent pandemic due to COVID-19 has caused greater concern and primary dental care practices temporarily suspended all aerosol generating and invasive procedures in the Ministry of Health in Bahrain, between February to August 2020. Dental emergencies were addressed using a triage system and low exposure procedures were undertaken. To identify the prescription and drug utilization of primary care dental practitioners during the period of suspension of aerosol generating dental practices due to COVID-19. Anonymized data from out-patient dental prescriptions from February 2020 to August 2020 were collected. Necessary data regarding the number, type and indication for prescription were collected and analyzed using appropriate statistical tests. 35.1% of patients were only prescribed medications without any dental intervention. 43.3% were irrational and 30.66% could not be evaluated for rationality of prescription due to lack of details on the diagnoses and the dental procedure that was carried out. Amoxicillin and amoxicillin/clavulanic acid amongst the antimicrobial class; and ibuprofen and acetaminophen amongst the analgesics, accounted for 90% of prescribed drugs. Chlorhexidine mouth rinse seemed to be on the regular list for any diagnoses, prescribed between 7 and 14 days, twice or thrice daily. Suspension of invasive and aerosol generating procedures may drive dentists to sort to prescriptions to manage their out-patients in primary care. Future antibiotic stewardship programs across the World must consider this additional factor and propose their recommendations.