Dental prescribing of antibiotics and opioids: high use in the absence of evidence

Guided by preliminary data, we will be pursuing 3 specific aims: 1) Identify trends in dental prescribing of antibiotics and opioid medications and identify patient and provider characteris-tics associated with high rates of inappropriate prescribing; 2) Compare dentists’ attitudes towards prescrib-ing antibiotics and opioids among those with high and low prescribing patterns in three Midwestern states; and 3) Develop a pilot implementation study to improve dental prescribing of antibiotics and opioids. The pro-posed study is aligned with the research priority areas of AHRQ (safer health care; improvements in health care practice, especially in ambulatory care) and 2 White House National Action Plans focused on antibiotic resistance and adverse drug events. We propose to conduct a mixed-methods study to assess antibiotic and opioid dental prescribing based on American Dental Association treatment recommendations and identify fac-tors related to prescribing. The expected outcomes of this study include providing baseline data on the extent of antibiotic and opioid overprescribing by dentists, identification of barriers and facilitators to improving pre-scribing of antibiotics and opioids and development of a pilot implementation project to improve the quality of dental care. Our long-term goal is to improve patient dental care by implementing interventions that will in-crease prudent antimicrobial use, decrease opioid overprescribing and decrease serious adverse events.