Dentists prescribe 1 in 10 antibiotics

U.S. dentists are a major source of outpatient antibiotic use, writing about one in 10 such prescriptions, according to a Healio report published August 5 and recent CDC and journal data. The figure has pushed dental prescribing higher on the antibiotic-stewardship agenda, an area long centered on hospitals and physician offices. CDC materials released in July say general dentists wrote 25.2 million antibiotic prescriptions in 2022, accounting for more than 10% of outpatient antibiotic use. ### Why are dentists such a large part of antibiotic prescribing? General dentists are the top specialty prescriber of outpatient antibiotics in the United States, according to peer-reviewed studies tracking national prescribing patterns. A 2024 Journal of the American Dental Association analysis found dentists’ share of outpatient antibiotic prescriptions rose above 10% during 2020-2022, even as overall outpatient prescribing fell. (healio.com) Dental care uses antibiotics in two main ways: to treat some oral infections and to prevent infection before procedures in selected high-risk patients. The CDC says antibiotics are the most prescribed medications by general dentists in outpatient settings. ### Where is the concern coming from? Published studies cited by the CDC and ADA say a substantial share of dental antibiotic use is unnecessary, suboptimal, or inconsistent with current guidance. (pmc.ncbi.nlm.nih.gov) The ADA says its evidence-based guideline for urgent management of pulpal- and periapical-related dental pain and intra-oral swelling recommends against antibiotics for most such conditions, favoring dental treatment and, when needed, over-the-counter pain relief. (cdc.gov) Research on prophylaxis has been especially pointed. A JAMA Network Open study cited in federal and ADA materials found 81% of antibiotic prophylaxis before dental procedures was unnecessary. CDC patient-safety guidance also says patients with total joint replacement commonly receive prophylactic antibiotics that may not be needed under ADA and American Academy of Orthopaedic Surgeons recommendations. (ada.org) ### Which prescribing situations draw the most scrutiny? Prophylaxis before dental procedures is one focus because guidance has narrowed the patients who should routinely receive antibiotics. The ADA says prophylactic antibiotics before dental procedures are generally not recommended for most patients with prosthetic joint implants, and should be reserved for patients at high risk of post-treatment complications. (hhs.gov) Urgent dental pain and swelling is another focus because antibiotics are often used when a procedure is the recommended treatment. The ADA guideline says most pulpal- and periapical-related pain and localized swelling should be managed with dental treatment rather than antibiotics alone. ### What are stewardship groups asking dentists to do differently? CDC guidance for outpatient dental settings calls for the same basic stewardship steps used elsewhere in medicine: prescribe only when needed, choose the right drug, and use the right dose and duration. (ada.org) The agency’s 2026 dental stewardship toolkit urges practices to track prescribing, increase awareness of treatment guidelines, and improve patient education. (ada.org) Healio’s August 5 article said collaboration between dentists and antibiotic-stewardship teams can improve prescribing and patient safety. A 2026 Open Forum Infectious Diseases study reported sustained improvement after stewardship education and dentist-facing prescribing dashboards, and said continued collaboration among dentists, infectious-disease experts, orthopedic surgeons and dental research networks would be essential. (cdc.gov) ### What changes next? The ADA told federal officials in comments on the next National Action Plan on Combating Antibiotic-Resistant Bacteria that dentistry should be included as a practical partner in national stewardship efforts. CDC has already issued outpatient dental stewardship resources dated July 1, 2026, and the ADA’s antibiotic stewardship and prophylaxis guidance pages remain the main reference points for dentists updating prescribing policies. (healio.com) (ada.org)