Prescribing patterns of analgesics and other medicines by dental practitioners in Australia from 2001 to 2012

Australian Dental Journal

Stewart

Marino

et al. 2018

The increase in the consumption of opioids is concerning, suggesting that continuing education is required for dentists to better understand their limited role in managing dental pain and potential for abuse. The substantial increase in the dispensed use of benzodiazepines also requires further investigation and there were some drugs prescribed inappropriately and not in accordance with guidelines. Consideration could also be given to reviewing the drugs listed on the PBS for dental prescribing.

Section: Discussionmentioning

confidence: 76%

Section: Introductionmentioning

confidence: 99%

Current prescribing trends of dental non‐antibacterial medicines in Australia from 2013 to 2016. Part 2.

Australian Dental Journal

Stewart

Marino

et al. 2018

“…Recent longitudinal studies in Australia show that dental dispensed opioids have been increasing in recent years, including Panadeine Forte, ® tramadol and oxycodone and that it is established that drug seeking and drug dependent patients are common in general dental practice. Therefore dentists should be aware of the increasing issues relating to prescribing drugs of dependence such as opioids and benzodiazepines and the importance of establishing a true therapeutic need .…”

Section: Misuse Of Pharmaceutical Drugsmentioning

confidence: 99%

Oral manifestations of illicit drug use

Australian Dental Journal

Moses

McCullough

2019

The use of illicit and misuse of licit drugs is a global public health problem, with illicit drug use being responsible for 1.8% of the total disease burden in Australia in 2011. Oral adverse effects associated with illicit drug use are well-established, with aggressive caries, periodontitis, bruxism, poor oral hygiene and general neglect documented. Other factors such as a high cariogenic diet and lifestyle, social and psychological factors compound the poorer oral health in illicit drug users. Literature has shown that the oral health-related quality of life among injecting drug users is poorer compared with the Australian general population and the overall quality of life of addicted people correlates with caries experience. Thus, the role of the dentist is imperative in managing the oral health of these individuals. Given their widespread recreational use, it is likely that dental practitioners will encounter patients who are regular or past users of illicit drugs. The aim of this article is to describe the prevalence and mechanism of action of commonly used illicit drugs in Australia, including cannabis, methamphetamine, cocaine and heroin and to inform dentists about the common orofacial presentations of their side effects to help with patient management.Abbreviations and acronyms: CBD = cannabidiol; CNS = central nervous system; MA = methamphetamine; ONJ = osteonecrosis of the jaw; THC = delta-9 tetrahydrocannabinol.

“…There is limited literature on dental prescribing of other medicines, but two retrospective studies in Australia indicated some divergence from guidelines for analgesic and anxiolytic prescribing, showing increasing dental use of opioids and benzodiazepines …”

Section: Introductionmentioning

confidence: 99%

“…12 There is limited literature on dental prescribing of other medicines, but two retrospective studies in Australia indicated some divergence from guidelines for analgesic and anxiolytic prescribing, showing increasing dental use of opioids and benzodiazepines. 13,14 It is well established that the use, particularly unnecessary use, of antibiotics is a major contributor to the development of antibiotic resistance. Appropriate prescribing, according to evidence-based indications, is therefore a professional responsibility of all clinicians, as collective use affects not only the individual but also the whole community and entire populations.…”

Section: Introductionmentioning

confidence: 99%

Perceptions, attitudes and factors that influence prescribing by general dentists in Australia: A qualitative study

J Oral Pathology Medicine

Stewart

Mariño

et al. 2019

Background Longitudinal studies of dental prescribing in Australia show that dentists make some inappropriate prescribing choices; literature has shown that dentists tend to overprescribe antibiotics and prescribe for incorrect indications. The unnecessary use of antibiotics is a contributing factor towards the development of antibiotic resistance. The aims of the study were to obtain a greater understanding of the perceptions, attitudes and factors that influence dental prescribing for all major relevant drug classes. Method Semi‐structured interviews of 15 purposively sampled dentists practising in Victoria, Australia were conducted from June–September 2018. Two dentists practised in rural areas and the remainder in urban locations. The range of clinical experience varied from 2.5 to 37 years, with a mean of 13 years. The transcripts were analysed thematically. Results Dentists generally preferred amoxicillin as first‐line therapy for odontogenic infections, with some confusion about the spectrum and uses of antibiotics. Overprescribing was evident, mostly due to basing judgement for use of antibiotics on symptoms rather than clinical signs. Other factors, such as time pressure, patient expectations, pressure from assistant staff, concern about online criticism and medico‐legal considerations, influenced prescribing. Of the dentists who prescribed anxiolytics, most did not have a care protocol for their sedated patients. Conclusion A variety of prescribing practices were described, and future interventions should target misconceptions around the appropriate use and choice of antibiotics, resources to address the shortfall in knowledge of therapeutics, patient education and staff training, as well as appropriate care and monitoring of sedated patients.