Say AHHH to AMR! Public perceptions about toothache, antibiotics and resistance

Background: Antibiotics don’t cure toothache, yet evidence exists that the general public assume antibiotics are necessary and appropriate(1). Dentistry is responsible for around 10% of antibiotic use across human healthcare globally(2), with up to 90% found not to be in line with evidence-based clinical guidelines(3,4). The misuse and overuse of antibiotics is increasing the risk of life-threatening infections which are resistant to antibiotics(5).<br/><br/>This students (QA/AA) collected data at the University of Manchester community festival in 2024 (6).<br/><br/>Aim: To understand public views about toothache, antibiotics and AMR.<br/><br/>Methods: Members of the public at the University of Manchester community festival in May 2024 were invited to answer questions testing their knowledge and beliefs about toothache, antibiotics and AMR. There were no restrictions on participation. Participants scanned a QR code on their own <br/>personal digital device to access the online survey (including consent form) in Qualtrics.<br/><br/>Results: 40 participants started and 39 completed the survey, of which 60% (n=24/40) had previously experienced severe toothache.<br/><br/>Highlights from the responses about toothache are that 40% (n= 16/40) expected antibiotics from their dentist for severe toothache of which half <br/>(n=7) said that they would seek them from another practitioner if their dentist did not prescribe them (Figure 1).<br/><br/>Paying for their dental care privately would increase their expectation to be prescribed antibiotics for toothache.<br/><br/>Highlights from the responses about AMR are that more than half (n=21) felt they were at no risk of resistance if taking antibiotics correctly (Figure 2). Whilst two-thirds (n=27) recognized antibiotics as reducing infection, a quarter (n=10) thought they reduced inflammation.<br/><br/>Exploring the impact of different AMR terminology showed that 60% preferred antibiotic related phrases over terminology involving antimicrobial or drug-resistance (Figure 3).<br/><br/>Conclusions: Antibiotic seeking behaviour for severe toothache was confirmed, with most respondents feeling at little personal risk from AMR. Paying privately for care was identified to increase expectation for antibiotics. Antibiotic related terminology seems to be the most impactful among the <br/>public.