Antibiotics prescribing habits of Brazilian general dental practitioners during periodontal treatments

CERIBELLI, Ariane Oliveira; ALVES, Brenda Stephanie Batista; TAJIMA, Thais Marques do Nascimento; MARTINS, Christine Men; BATISTA, Victor Eduardo de Souza; SANTINONI, Carolina dos Santos

doi:10.1590/1807-2577.02623

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Revista de Odontologia da UNESP

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Original Article • Rev. Odontol. UNESP 52 • 2023 • https://doi.org/10.1590/1807-2577.02623 copy

Antibiotics prescribing habits of Brazilian general dental practitioners during periodontal treatments

Hábitos de prescrição de antibióticos de dentistas brasileiros durante tratamentos periodontais

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Introduction

Periodontal treatment involves procedures aimed to reduce bacterial load, involving or not the use of local or systemic antibiotics.

Objective

The purpose of this study was to assess Brazilian dentists’ knowledge about antibiotics prescription during periodontal treatment.

Material and method

An online questionnaire was available asking for systemic application of local or systemic antibiotics prescription (frequency, and sequence with mechanical periodontal treatment) and in relation to different periodontal diseases. The use of microbial diagnostic services and volunteers’ demographic data were also elucidated. Data were statistically analyzed (Binomial Test, p<0.05).

Result

Three hundred and ninety-three volunteers answered the questionnaire. Twenty-three percent males and 76.2% females. Average age was 27.7 years. Minority (19.2%) of the volunteers reported to indicate systemic antibiotics to treat gingivitis or periodontitis stages I and II (old slight and moderate chronic periodontitis). Majority of the professionals indicate it to treat periodontal abscess, necrotizing ulcerative gingivitis or periodontitis, periodontitis in severe immunodeficiencies, old aggressive periodontitis, and periodontitis stages III and IV (old severe chronic periodontitis). Rarely (2.5%) the prescription was without the combination with mechanical therapy. Microbiological tests as an auxiliary diagnostic method are rarely (3.1%) requested due to lack of information or cost. Most frequent answers about the number of times professionals reported prescribing systemic antibiotics as part of periodontal treatment per trimester was “at least once”, followed by “2 times”.

Conclusion

It can be concluded that Brazilian dentists have knowledge about the correct prescription of antibiotics in periodontal therapy.

Descriptors:
Dentistry; periodontics; antibiotics; questionnaire

1. Do you offer periodontal treatment in your office?
	Yes
	No, I do refer to the specialist (please, go to the question number 10)
2. For which of the following diseases do you usually recommend systemic use of antibiotics? (It is possible to select more than one option)
Diseases
	Biofilm-induced gingivitis in normal periodontium
	Biofilm-induced gingivitis in reduced periodontitis (old refractory periodontitis)
	Periodontitis stage I (old slight chronic periodontitis)
	Periodontitis stage II (old moderate chronic periodontitis)
	Periodontitis stages III and IV (old severe chronic periodontitis)
	Old aggressive periodontitis
	Periodontal abscess (pericoronary, gingival or periodontal)
	Necrotizing ulcerative gingivitis
	Necrotizing ulcerative periodontitis
	Periodontitis in severe immunodeficiencies (HIV, leukemia, etc.)
	Health in normal or reduced periodontal
3. Do you administer antibiotics (systemic) to perform periodontal treatment, as the sole therapeutic agent (without mechanical therapy)?
	Yes
	No, I do refer to the specialist (please, go to the question number 10)
4. At what point do you administer (systemic) antibiotics as adjuvants to mechanical therapy? (NOTE: refers to the treatment of periodontal disease and does not include cases of prophylactic antibiotic therapy)
	Before starting mechanical therapy
	During mechanical therapy
	After starting mechanical therapy
5. Do you use local antibiotics?
	No (please, go to the question number 7)
	Yes, for the following diseases: (it is possible to select more than one option)
		Chronic events (Ex: periodontitis)
		Acute events (Ex: periodontal abscess)
		Recurrent diseases (Ex: Biofilm-induced gingivitis in reduced periodontium (old refractory periodontitis)
		Others:
6. Which local antimicrobials do you prefer to use? (It is possible to select more than one option)
	Doxycycline
	Chlorhexidine
	Tetracycline
	Others:
7. Do you sometimes use microbiological tests to aid in the diagnosis of periodontitis?
	No (please, go to the question number 10)
	Yes
8. What microbiological tests do you use?

9. Why do you use microbiological tests? (It is possible to select more than one option)
	To choose the appropriate antibiotic therapy
	Suspicion of Aggregatibacter actinomycetemcomitans
	Improve patient motivation with poor oral hygiene
	For patients who have a private health plan
	To control therapy success
	Residual pockets
	Routinely in the following diseases:
	Others:
Please, go to the question number 11
10. Why you do not you use microbiological tests? (It is possible to select more than one option)
	High cost
	Lack of information
	I don't see advantages
	Bad experiences in the past
	Others:
11. How many years have you been practicing Dentistry?

12. How old are you?

13. What is your gender?
	Female
	Male
14. Over the past two years, I have participated in classes / courses / training on the use of antibiotics in the treatment of periodontitis
	Yes
	No
15. The number of times I prescribe (systemic) antibiotics as part of periodontal treatment, per trimester is:
	1
	2
	3
	4
	5
	More than 5

%	Periodontal diseases
Diseases without generally accepted recommendation for antibiotic prescription
0.3	Biofilm-induced gingivitis in normal periodontium
2.2	Biofilm-induced gingivitis in reduced periodontitis (old refractory periodontitis)
3.6	Periodontitis stage I (old slight chronic periodontitis)
12.5	Periodontitis stage II (old moderate chronic periodontitis)
0.6	Health in normal or reduced periodontal
Diseases with generally accepted recommendation for antibiotic prescription
39	Periodontitis stages III and IV (old severe chronic periodontitis)
46	Old aggressive periodontitis
84.1	Periodontal abscess (pericoronary, gingival or periodontal)
52.9	Necrotizing ulcerative gingivitis
67.7	Necrotizing ulcerative periodontitis
50.1	Periodontitis in severe immunodeficiencies (HIV, leukemia, etc.)
13.6	For cases where periodontal surgery is contraindicated

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[1] CONFLICTS OF INTERESTS

The authors declare no conflicts of interest.