Evaluation of Dentists’ Knowledge, Opinions and Behaviours About The Use of Antibiotics in Impacted Wisdom Tooth Extraction

Year 2024, Volume: 13 Issue: 2, 347 - 357, 20.05.2024

Zeynep Nazlı Saat Gökhan Hakkı Alpaslan

https://doi.org/10.54617/adoklinikbilimler.1397425

Abstract

Aim: The aim of this study was to evaluate the knowledge, thoughts, behaviours and approaches of dentists about antibiotic use in impacted wisdom teeth extraction.
Materials and Method: A questionnaire form consisting of 36 questions about demographic information, indications for extraction of impacted wisdom teeth, complications that may occur, prescribed drugs and their duration of use, criteria for drug selection, preoperative and postoperative approaches, and radiological evaluation criteria was applied to 468 dentists participating in the study. Chi-square and Fisher Chi-square analyses were used to determine the relationship between categorical data. The significance level was accepted as 0.05 in all statistical analyses.
Results: The clinical experience of dentists was found to influence their choice of antibiotics. For patients with penicillin allergy, dentists usually chose alternative antibiotics to penicillin such as clindamycin or metronidazole. Reasons for preference also influenced the choice of antibiotics. Dentists chose antibiotics based on the information they learnt in their pre-graduation education, by making use of clinical guidelines written on the subject or by using antibiotics combined with clavulonic acid or sulbactam in order not to take risks (p<0.05).
Conclusion: The findings obtained within the scope of the study reveal that it is important to increase the awareness of dentists about antibiotic use in impacted wisdom tooth extraction. In addition, as a result of the study, it is recommended that educational strategies related to rational drug use in our country should be established especially from the student period.

Keywords

Antibiotherapy, wisdom, operation, prophylaxis

Diş Hekimlerinin Gömülü Yirmi Yaş Diş Çekiminde Antibiyotik Kullanımı Hakkında Bilgi, Düşünce ve Davranışlarının Değerlendirilmesi

Abstract

Amaç: Bu çalışmanın amacı gömülü yirmi yaş diş çekiminde diş hekimlerinin antibiyotik kullanımı hakkında bilgi, düşünce, davranış ve antibiyotik kullanımı yaklaşımlarının değerlendirilmesidir.
Gereç ve Yöntem: Çalışmaya katılan 468 diş hekimine 36 sorudan oluşan demografik bilgiler, gömülü yirmi yaş diş çekimi endikasyonları, oluşabilecek komplikasyonlar, reçete edilen ilaçlar ve kullanım süreleri, ilaç seçimindeki kriterleri, preoperatif ve postoperatif dönemdeki yaklaşımları, radyolojik değerlendirme kriterleri ile ilgili sorulardan oluşan anket formu uygulanmıştır. Kategorik veriler arasında ilişkinin tespiti için Ki-kare ve Fisher Ki-kare analizi kullanılmıştır. Yapılan tüm istatiksel analizlerde anlamlılık düzeyi 0.05 olarak kabul edilmiştir.
Bulgular: Diş hekimlerinin klinik deneyimlerinin antibiyotik seçimlerini etkilediği görülmüştür. Penisilin alerjisi olan hastalar için, diş hekimleri genellikle klindamisin veya metronidazol gibi penisiline alternatif antibiyotik seçimleri yapmışlardır. Antibiyotik seçiminde tercih nedenleri de antibiyotik seçimlerini etkilemiştir. Diş hekimleri, mezuniyet öncesi eğitimlerinde öğrendikleri bilgilere dayanarak, konu ile ilgili yazılmış olan klinik rehberlerden yararlanarak veya risk almamak için mutlaka klavulonik asit veya sulbaktam ile kombine edilmiş antibiyotikleri kullanarak antibiyotik seçimleri yapmışlardır (p<0.05).
Sonuç: Çalışma kapsamında elde edilen bulgular diş hekimlerinin gömülü yirmi yaş diş çekiminde antibiyotik kullanımı farkındalığının artırılmasının önemli olduğunu ortaya koymaktadır. Ayrıca çalışma sonucunda ülkemizde akılcı ilaç kullanımı ile ilgili eğitim stratejilerinin özellikle öğrencilik döneminden itibaren oluşturulması gerektiği önerilmektedir.

Keywords

antibiyoterapi, gömülü, operasyon, profilaksi

References

• Peterson LJ, Ellis E, Hupp JR, Tucker MR. Contemporary oral and maxillofacial surgery. Mosby 3rd. ed. 1998. P. 215- 237.
• Üçok C, Katı Ş, Karaahmetoğlu Ö. Yirmi yaş dişlerinin çekim kararının sosyal güvenlik sistemine etkileri. EADS 2016;43:2-63.
• Von Wovern N, Nielsen HO. The fate of impacted third molars after the age of 20. A four year clinical follow up. Int J Oral Maxillofac Surg 1989;18:5:277-80.
• Yeler D, Çine N, Yeler H. Diş hekimliğinde enfektif endokardit riski ve profilaksi gerekliliği. Cumhuriyet Dent J 2011;14;133-9.
• Sologova D, Diachkova E, Gor I, Sologova S, Grıgorevskikh E, Arazashvili L, et al. Antibiotics efficiency in the infection complications prevention after third molar extraction: A Systematic review. Dent J (Basel) 2022;10:72.
• Ndukwe KC, Braimah RO, Owotade JF, Aregbesola SB. Comparative efficacy of amoxicillin/clavulanic acid and levofloxacin in the reduction of postsurgical sequelae after third molar surgery: A randomized, double-blind, clinical trial in a. Nigerian University Teaching Hospital. Niger J Surg 2016;22;70-6.
• Vlcek D, Razavi A, Kuttenberger JJ. Antibiotics in third molar surgery. Swiss Dent J 2014;124:294-302.
• Altındiş M, Gümüşsoy İ, İnci B, Furuncuoğlu F, Altındiş S. Diş hekimliğinde antibiyotik kullanımı. 1. Uluslararası Dental ve Oral Enfeksiyonlar Kongresi, 07-09 Eylül 2018 Sakarya-Türkiye.
• Bennett JE, Dolin R, Blaser MJ. Mandell, Douglas, and Bennett’s principles and practice of infectious diseases. Diseases E-Book: 2-Volume Set. Elsevier health sciences 2019;1:1–3697.
• Cervino G, Cicciù M, Biondi A, Bocchieri S, Herford AS, Laino L, et al. Antibiotic prophylaxis on third molar extraction: Systematic review of recent data. Antibiotics (Basel) 2019;8:53.
• Ventola CL. The antibiotic resistance crisis: Part 1: Causes and Threats. PT 2015;40:277-83.
• Premanandh J, Samara BS, Mazen AN. Race against antimicrobial resistance requires coordinated action–an overview. Front Microbiol 2016;6:1536.
• Lodi G, Azzi L, Varoni EM, Pentenero M, Del Fabbro M, Carrassi A, et al. Antibiotics to prevent complications following tooth extractions. Cochrane Database Syst Rev 2021;24:CD003811.
• Sancho-Puchades M, Herraez-Vilas JM, Valmaseda-Castellon E, Berini-Aytes L, GayEscoda C. Analysis of the antibiotic prophylaxis prescribed by Spanish oral surgeons. Med Oral Patol Oral Cir Bucal 2009;14:e533–7.
• Kohler M, Meyer J, Linder M, Lambrecht JT, Filippi A, Kulik Kunz EM. Prescription of antibiotics in the dental practice: a survey of dentists in Switzerland. Schweiz Monatsschr Zahnmed 2013;123:748–59.
• Demirbas F, Gjermo PE, Preus HR. Antibiotic prescribing practices among Norwegian dentists. Acta Odontol Scand 2006;64:355– 9.
• Bezerra TP, Studart-Soares EC, Scaparo HC, Pita-Neto IC, Batista SH, Fonteles CS. Prophylaxis versus placebo treatment for infective and inflammatory complications of surgical third molar removal: a split-mouth, double-blind,. controlled, clinical trial with amoxicillin (500 mg). J Oral Maxillofac Surg 2011;69:e333–9.
• Adde CA, Soares MS, Romano MM, Carnaval TG, Sampaio RM, Aldarvis FP, et al. Clinical and surgical evaluation of the indication of postoperative antibiotic prescription in third molar surgery. Oral Surg Oral Med Oral Pathol Oral Radiol 2012;114:26–31.
• Pasupathy S, Alexander M. Antibiotic prophylaxis in third molar surgery. J Craniofac Surg 2011;22:551-3.
• Arteagoitia I, Diez A, Barbier L, Santamarı G, Santamarı J. Efficacy of amoxicillin/clavulanic acid in preventing infectious and inflammatory complications following impacted mandibular third molar extraction. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2005;100:11–8.
• Milani BA, Bauer HC, Sampaio-Filho H, Horliana AC, Perez FE, Tortamano IP, et al. Antibiotic therapy in fully impacted lower third molar surgery: randomized three-arm, double-blind, controlled trial. Oral Maxillofac Surg 2015;19:341–6.
• Lawler B, Sambrook P, Goss A. Antibiotic prophylaxis for dentoalveolar surgery: is it indicated? Aust Dent J 2005;50:54–9.
• Siddiqi A, Morkel JA, Zafar S. Antibiotic prophylaxis in third molar surgery: A randomized double-blind placebo-controlled clinical trial using split-mouth technique. Int J Oral Maxillofac Surg 2010;39:107-14.
• Yoshida K, Kodama Y, Nishikawa A, Estacio Salazar AR, Toyama A, Takagi R. Comparison between the prophylactic effects of amoxicillin 24 and 48 hours pre-operatively on surgical site infections in Japanese patients with impacted. mandibular third molars: A prospective cohort study. J Infect Chemother 2021;27:845-51.
• Bal F, Rodopman A. Dişhekimliğinde akut enfeksiyonların tedavisinde antibakteriyal ilaçların kullanımı. J Istanbul Univ Fac Dent 2012;31:110-6.
• Jayadev M, Karunakar P, Vishwanath B, Chinmayi SS, Siddhartha P, Chaitanya B. Knowledge and pattern of antibiotic and non narcotic analgesic prescription for pulpal and periapical pathologies a survey among dentists. J Clin Diagn Res 2014;8:ZC10-ZC14.
• Roda RP, Bagan JV, Bielsa JMS, Pastor EC. Antibiotic use in dental practice. A review. Med Oral Patol Oral Cir Bucal 2007;12:E186-92.
• Gupta N, Safhi MM, Sumaily JM, Nayeem M, Agarwal M, Siddiqui AH. A study on the prescription pattern of drugs in Jazan general hospital, KSA. African Journal of Pharmacy and Pharmacology 2016;10:7-13.
• Iglesias-Martin F, Garcia-Perla-Garcia A, Yanez-Vico R, Aced-Jimenez E, Arjona-Gerveno E, Gonzalez-Padilla JD, et al. Comparative trial between the use of amoxicillin and amoxicillin clavulanate in the removal of third molars. Med Oral Patol Oral Cir Bucal 2014;19:e612-e615.
• Zhang J, Chen L, Gomez-Simmonds A, Yin MT, Freedberg DE. Antibiotic-Specific Risk for Community-Acquired Clostridioides difficile Infection in the United States from 2008 to 2020. Antimicrob Agents Chemother 2022;66:e0112.