The Role of Antimicrobial Stewardship in Dentistry: Current Landscape and Prospects for the Future

Antimicrobial resistance (AMR) is a worldwide health emergency, accounting for millions of deaths every year. 7–10% of community antibiotic prescriptions are from dentistry, frequently in contexts where operative management would be preferable. This misuse speeds up resistance, drives up the costs of healthcare, and puts patients at avoidable risk. Antimicrobial stewardship (AMS) within dentistry is therefore paramount to achieve rational prescription. Core principles of AMS include choosing the appropriate drug, dose, and duration while reducing undesirable outcomes and maintaining antibiotic effectiveness. Recommendations are made to prioritize dental interventions like extraction, root canal, or drainage, with antibiotic use limited to systemic infection or high-risk individuals. Successful AMS strategies involve professional education, audit with feedback, guideline dissemination, and application of digital decision-support systems. Patient education and engagement with physicians and pharmacists also support stewardship activities. The following barriers, however, impede the way forward: poor adherence, constraints of resources, limited IT infrastructure, and patient demand. There is a need for sustainable policies, ongoing professional development, and strong surveillance frameworks to bridge AMS into established dental practice.