Healthcare Challenges and Future Solutions in Dental Practice: Assessing Oral Antibiotic Resistances by Contemporary Point-Of-Care Approaches

Abstract

Antibiotic resistance poses a global threat, which is being acknowledged at several levels, including research, clinical implementation, regulation, as well as by the World Health Organization. In the field of oral health, however, the issue of antibiotic resistances, as well as of accurate diagnosis, is underrepresented. Oral diseases in general were ranked third in terms of expenditures among the EU-28 member states in 2015. Yet, the diagnosis and patient management of oral infections, in particular, still depend primarily on empiric means. On the contrary, on the global scale, the field of medical infections has more readily adopted the integration of molecular-based systems in the diagnostic, patient management, and antibiotic stewardship workflows. In this perspective review, we emphasize the clinical significance of supporting in the future antibiotic resistance screening in dental practice with novel integrated and point-of-care operating tools that can greatly support the rapid, accurate, and efficient administration of oral antibiotics.

Profiling Antibiotic Susceptibility among Distinct Enterococcus faecalis Isolates from Dental Root Canals

“…Amoxicillin is frequently the first choice for treating bacterial infections in the oral cavity due to its broad spectrum activity against typical oral pathogens and its favorable pharmacokinetics [54,55]. The most frequent resistance mechanism in E. faecalis involves mutations that simultaneously alter PBP4 s affinity for amoxicillin and overexpress the modified enzyme [56,57].…”

A critical analysis of research methods to study clinical molecular biomarkers in Endodontic research

“…To collect biomarkers non-invasively in the oral cavity, saliva is a central favourite medium to collect and study, due to its extreme ease at sampling and plethora of parameters to analyse, including high prediction microbiological and immunological biomarkers for dental caries and periodontal disease (Paqué et al, 2020(Paqué et al, , 2021, or qualitative detection of antibiotic resistance genes (Belibasakis et al, 2020). Saliva sampling may also conveniently replace the uncomfortable nasal or oropharyngeal sampling for select applications, such as SARS-CoV-2 RNA detection, with high specificity and sensitivity (Atieh et al, 2021).…”

Clinical laboratory diagnostics in dentistry: Application of microbiological methods

“…These molecular platforms enable a very rapid sampling-to-answer pipeline (i.e., within a patient session). Chair-side assays under development include molecular quantification of periodontal or cariogenic species [ 40 – 42 ] or the detection of antibiotic resistance genes [ 43 ] within oral samples.…”