Antibiotic Prescribing in Dentistry + Gut Microbiome – PDP254

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When are antibiotics truly indicated in dentistry?

How do you manage the patient who’s begging for a prescription?

And what impact are we having on the gut every time we prescribe unnecessarily?

In this episode, Dr. Jeremy Lenaerts joins Jaz to explore the world of antibiotics in dentistry. Together, they cover when to prescribe, when not to, and why analgesics or local measures are often the better option.

They also dive into the bigger picture—antibiotic resistance, gut health, and how to navigate those tricky conversations when patients demand antibiotics for the wrong reasons.

Protrusive Dental Pearl? Save time and avoid confusion with a ready-made Antibiotics Cheat Sheet that combines the best guidelines into one resource. It covers:

• True indications and contraindications
• Drug interactions
• First, second, and third-line choices
• Doses and duration

👉 Download it or find it in the Protrusive Vault if you’re a Protrusive Guidance member.

Key Takeaways

• Antibiotics are often overprescribed in dentistry, with 80% deemed inappropriate.
• The gut microbiome plays a crucial role in overall health and can be negatively impacted by antibiotics.
• Educating patients about the risks of antibiotics is essential for informed consent.
• Local measures should be prioritized over antibiotics for dental infections.
• Antibiotics can lead to antibiotic resistance, affecting both individual and public health.
• The gut microbiome is increasingly recognized as a separate organ essential for health.
• Dentists should consider the long-term effects of antibiotics on gut health when prescribing.
• Patient communication is key in managing expectations around antibiotic prescriptions.
• A balanced diet rich in fiber and fermented foods supports gut health.
• Dentists must navigate the tension between patient demands and clinical guidelines.

Highlights of this episode:

• 00:00 Teaser
• 00:37 Intro
• 02:25 Protrusive dental podcast
• 04:10 Dr. Jeremy’s Journey into Dentistry
• 07:47 Antibiotic Use in Dentistry
• 10:28 True Indications for Antibiotics
• 14:12 Impact of Antibiotics on Gut Health
• 21:09 Clinical Scenarios and Best Practices
• 26:09 Managing Severe Dental Swellings
• 26:28 Midroll
• 29:49 Managing Severe Dental Swellings
• 33:39 Techniques for Anesthetizing Abscesses
• 38:06 Handling Cellulitis and Systemic Infections
• 42:58 Dosage and Safety of Local Anesthetics
• 44:58 Dealing with Dry Sockets and Retreated Teeth
• 47:43 Outro

Updated SDCEP Guidance

For clinicians in the UK, Drug Prescribing for Dentistry is now available through the dedicated website SDCEP Dental Prescribing.

Please note that SDCEP no longer provides updates to the printed guidance, and the Dental Prescribing app is no longer supported or updated—it should be deleted from all devices. The SDCEP Dental Prescribing website is now the authoritative source for the most up-to-date information on prescribing in dental practice.

We are also providing the 2016 PDF version of Drug Prescribing for Dentistry for reference, but users should be aware that this document is no longer maintained and may not reflect the latest clinical guidance.

Download the 2016 PDF here.

If you enjoyed this episode, you’ll also find value in Prescribing Antifungals as a GDP – Diagnosis and Management (PDP151)

#PDPMainEpisodes #Communication #BreadandButterDentistry #CareerDevelopment

This episode is eligible for 0.75 CE credit via the quiz on Protrusive Guidance. 

This episode meets GDC Outcomes C and D.

AGD Subject Code: 340 (Prescription medication management)

Aim: To enhance clinicians’ confidence in the rational prescribing of antibiotics in dentistry, with an understanding of when they are indicated, when they are not, and the broader impact on antimicrobial resistance and gut health.

Dentists will be able to –

1. Identify the true clinical indications for antibiotic use in dentistry.
2. Recognize when local measures (drainage, extraction) are preferable to antibiotics.
3. Explain the impact of antibiotic use on antimicrobial resistance and the gut microbiome.
4. Apply current guidelines (e.g., SDCEP) in clinical scenarios involving dental infections.