Appropriateness of Antibiotic Prophylaxis Before Dental Procedures, 2016–2018

Colin C. Hubbard, Charlesnika T. Evans, Gregory S. Calip, Jifang Zhou, Susan A. Rowan, Katie J. Suda*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Introduction: Prescribing antibiotic prophylaxis is common yet unnecessary for many dental visits. In this analysis, our objective was to assess whether the appropriateness of antibiotic prophylaxis has improved over time. Methods: A retrospective cohort study was conducted using dental visits from 2016 to 2018 (data analyzed in 2021) using medical and prescriptions claims data of patients from the U.S. with commercial dental insurance. Antibiotic prophylaxis was defined as a ≤2 days’ supply prescription dispensed within 7 days before a dental visit. Appropriateness of prophylaxis was defined on the basis of the manipulation of the gingiva/tooth periapex or oral mucosa perforation in patients with appropriate cardiac diagnoses. Associations between patient and visit characteristics and appropriateness of antibiotic prophylaxis were assessed using multiple Poisson regression. Results: Unnecessary antibiotic prophylaxis was highly prevalent in this cohort, ranging from 77.0% in 2016 to 78.5% in 2018. In the adjusted analysis, factors associated with unnecessary antibiotic prophylaxis included younger age, female sex, geographic region, rurality, type of antibiotic, and certain dental procedures. The factors associated with the highest risk of unnecessary prophylaxis in the adjusted analysis were orthodontic procedures and having a history of a prosthetic joint. Notably, the risk of unnecessary antibiotic prophylaxis decreased over time in the adjusted analysis. Conclusions: Unnecessary prescription of antibiotic prophylaxis by dentists continues to be common. Antimicrobial stewardship strategies are needed to improve prescribing by dentists.

Original languageEnglish (US)
Pages (from-to)943-948
Number of pages6
JournalAmerican Journal of Preventive Medicine
Issue number6
StatePublished - Jun 2022

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health


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