About This Toolkit

Antimicrobial resistance is recognized as one of the top ten global public health threats by the World Health Organization. In Canada, the proportion of infections resistant to antimicrobials is anticipated to increase from 26% in 2018 to 40% by 2050. Additionally, in 2021, nearly 73.6%, of the total antimicrobial consumption in Canada consisted of antibiotics from groups commonly prescribed for tooth pain, exceeding the World Health Organization’s country specific target benchmark of 60%.

Historically, dentists have prescribed antibiotics for tooth pain; however this practice is not supported by evidence, as the majority of tooth pain cases can be managed with a dental procedure, pain medication, or both.4,5 Dental prescriptions are an important contributor to the problem of antimicrobial resistance for the following reasons:

• Research has shown that up to 80% of antibiotics prescribed by dentists are considered unnecessary.
• In 2022, dentists accounted for 9.6% of all antibiotic prescriptions in Canada
• The overall proportion of antibiotics prescribed by Canadian dentists is rising.

The unnecessary use of antibiotics not only contributes to this global threat but can also cause side effects to patients and, occasionally, more serious harms. Antibiotics must be reserved for serious infections where there is evidence of clinical effectiveness.

Purpose

The focus of this toolkit is on managing tooth pain and determining when it is appropriate to prescribe antibiotics. The guidance in this toolkit applies to adult patients, including those with medical complexity, who are capable of producing an immune response to a bacterial challenge.

Target Audience

This toolkit is intended for dentists, physicians, and other health care professionals managing adults presenting with tooth pain in settings where dental treatment may or may not be immediately available.