Agnihotry Anirudha, Gill Karanjot Singh, Stevenson Iii Richard G, Fedorowicz Zbys, Kumar Vijay, Sprakel Julie, Cohen Stephen, Thompson Wendy
Family HealthCare Network, Porterville, CA, USA.
University of Detroit Mercy, School of Dentistry, Detroit, MI, USA.
Braz Dent J. 2019 Jul 22;30(4):374-379. doi: 10.1590/0103-6440201902873.
Antibiotic resistance is a growing public health concern. Antibiotics continue to be prescribed by some clinicians to resolve dental pain even though research indicates that antibiotics are not effective for treating conditions such as irreversible pulpitis. The objective of this study was to determine the extent to which current research and evidence around irreversible pulpitis has been translated into dental practice and the gaps in dentists' knowledge. An on-line clinical vignette format survey questionnaire about treatment of irreversible pulpitis was distributed to the members of the Academy of Operative Dentistry and Academy of General Dentistry (US based international dental bodies). Their responses were recorded and evaluated. A total of 403 dentists participated in the survey. Over a third (39.3%) indicated they would prescribe antibiotics for symptomatic irreversible pulpitis in a permanent tooth occurring without any signs of systemic infection. The rest indicated they would not prescribe antibiotics; most of them would prescribe an analgesic combined with pulpectomy. Those who had undertaken advanced education training achieved a significantly higher mean knowledge score compared to those with just a primary dental degree (p=0.011). Similarly, full or part time academicians had a higher mean knowledge score than the clinicians who work only in private practice (p=0.014). Some dentists continue to prescribe antibiotics inappropriately for alleviating pain due to irreversible pulpitis. Antibiotic prescribing practices of dentists with advanced education or academic engagement were better as compared to the other participants. There is clear evidence of antibiotic over-prescribing for irreversible pulpitis which needs to be addressed urgently.
抗生素耐药性日益引起公众对健康的关注。尽管研究表明抗生素对治疗诸如不可复性牙髓炎等病症无效，但一些临床医生仍继续开具抗生素来缓解牙痛。本研究的目的是确定目前关于不可复性牙髓炎的研究和证据在牙科实践中的转化程度以及牙医知识方面的差距。一份关于不可复性牙髓炎治疗的在线临床病例格式调查问卷被分发给美国牙体牙髓病学会和全科牙医学会（总部位于美国的国际牙科组织）的成员。记录并评估他们的回答。共有403名牙医参与了调查。超过三分之一（39.3%）的人表示，对于一颗恒牙出现的有症状的不可复性牙髓炎且无任何全身感染迹象的情况，他们会开具抗生素。其余的人表示不会开具抗生素；他们中的大多数人会开具一种镇痛药并结合牙髓摘除术。与仅拥有初级牙科学位的人相比，接受过高等教育培训的人平均知识得分显著更高（p = 0.011）。同样，全职或兼职院士的平均知识得分高于仅在私人诊所工作的临床医生（p = 0.014）。一些牙医继续不恰当地开具抗生素以缓解不可复性牙髓炎引起的疼痛。与其他参与者相比，接受过高等教育或从事学术工作的牙医的抗生素处方行为更好。有明确证据表明，对于不可复性牙髓炎存在抗生素过度处方的情况，这需要紧急解决。
