CHICAGO: The American Dental Association (ADA) has called for a stronger and more clearly defined role for dentistry in the United States' next National Action Plan on Combating Antibiotic-Resistant Bacteria, arguing that dentists are uniquely positioned to help address one of the world's most pressing public health threats.
In formal comments submitted to federal health authorities, the ADA emphasized that dentistry should be recognized as a distinct and essential component of outpatient antibiotic stewardship efforts as policymakers prepare the next five-year national strategy covering 2026-2031.
The submission was sent to the Presidential Advisory Council on Combating Antibiotic-Resistant Bacteria (PACCARB) and the Federal Inter-Agency Combating Antibiotic-Resistant Bacteria Task Force, both of which are gathering expert input to shape the next phase of the United States' response to antimicrobial resistance.
Why antibiotic resistance remains a growing global threat
Antibiotic resistance, often referred to as antimicrobial resistance (AMR), occurs when bacteria evolve and no longer respond effectively to medicines that once treated infections successfully.
The World Health Organization has repeatedly identified antimicrobial resistance as one of the most serious threats to global health, food security, and development. Resistant infections can lead to longer illnesses, increased healthcare costs, more complicated treatments, and higher mortality rates.
Health experts warn that inappropriate antibiotic prescribing across all areas of healthcare contributes to the problem by accelerating the emergence of drug-resistant bacteria.
ADA highlights dentistry's significant prescribing role
In its submission, the ADA pointed to data from the US Centers for Disease Control and Prevention (CDC) showing that general dentists account for more than 10% of outpatient antibiotic prescriptions in the United States.
Given this substantial contribution to overall antibiotic use, the association argued that dentistry should be formally recognized as a priority partner in national stewardship initiatives.
The ADA noted that improving prescribing practices within dental settings represents an important opportunity to reduce unnecessary antibiotic exposure while maintaining high standards of patient care.
"Dentistry is a distinct and important component of outpatient antibiotic stewardship," the association wrote in its comments to federal officials.
Dentists urged to lead by example
ADA President-elect Dr. Thomas Paumier stressed that dentists have both a professional and ethical responsibility to use antibiotics appropriately.
"As a profession, and individually, we have a responsibility to be better antibiotic stewards," Dr. Paumier said.
Invoking the longstanding medical principle "Primum non nocere" or "First, do no harm," he emphasized that recognizing the risks associated with unnecessary antibiotic use is a critical step toward protecting patients and preserving the effectiveness of life-saving medications.
Dr. Paumier warned that antimicrobial resistance represents a looming healthcare crisis requiring immediate action from all sectors of healthcare, including dentistry.
Community dental practices face unique challenges
A key theme of the ADA's recommendations was the need for stewardship strategies that reflect the realities of dental practice.
Unlike many hospitals and large healthcare systems, most dental care in the United States is delivered through community-based practices, including small and solo clinics that often lack dedicated antimicrobial stewardship teams or specialized infrastructure.
The association cautioned policymakers against creating one-size-fits-all stewardship requirements that may be difficult for dental practices to implement.
Instead, the ADA recommended practical support measures such as clinician education, clinical decision-support resources, patient education materials, and quality improvement tools specifically designed for dental settings.
Evidence-based prescribing remains central
The association also highlighted its 2019 evidence-based clinical practice guideline on antibiotic use for urgent management of pulpal- and periapical-related dental pain and intraoral swelling.
The guideline advises that antibiotics should not be routinely prescribed for most dental pain and localized dental infections when definitive dental treatment can be provided.
Instead, the ADA recommends prioritizing conservative dental interventions that address the underlying cause of infection rather than relying on antibiotics alone.
Experts say this approach can help reduce unnecessary antibiotic exposure while improving patient outcomes.
Protecting clinical judgment
While advocating for stronger stewardship efforts, the ADA also cautioned against policies that could inadvertently discourage appropriate prescribing for patients who genuinely require antibiotics.
The association emphasized that stewardship should focus on reducing inappropriate use rather than restricting evidence-based treatment decisions.
According to the ADA, clinicians must retain the flexibility to prescribe antibiotics when supported by clinical guidelines and individual patient needs, particularly among high-risk populations.
Key recommendations for the next national action plan
As federal officials prepare the 2026-2031 National Action Plan on Combating Antibiotic-Resistant Bacteria, the ADA outlined several priorities:
• Recognize dentistry as a key outpatient antibiotic stewardship partner.
• Support implementation of evidence-based dental prescribing guidelines.
• Strengthen access to definitive dental treatment.
• Develop stewardship resources tailored for community-based dental practices.
• Encourage voluntary, data-driven quality improvement initiatives.
• Expand educational programs that help dentists optimize prescribing practices.
Research shows stewardship efforts can work
The ADA also cited research demonstrating that dental stewardship programs can successfully improve prescribing behavior.
According to the association, studies have found that combining stewardship education with audit-and-feedback programs helped private-practice dentists reduce antibiotic treatment duration and decrease reliance on clindamycin, an antibiotic often associated with higher risks of adverse effects.
These findings suggest that targeted interventions can produce meaningful improvements when specifically designed for dental practice environments.
A crucial moment for oral healthcare and public health
The recommendations arrive as health authorities worldwide intensify efforts to combat antimicrobial resistance, which continues to threaten decades of progress in modern medicine.
With the next National Action Plan expected to guide US policy through 2031, the ADA says dentistry must be fully integrated into national efforts to preserve antibiotic effectiveness and protect future generations from drug-resistant infections.
The association has pledged to continue working with PACCARB, the Department of Health and Human Services, the CDC, and other federal partners as policymakers develop the country's next antibiotic resistance strategy.
As antibiotic-resistant infections continue to rise globally, experts increasingly agree that responsible prescribing across every healthcare profession—including dentistry—will be essential to slowing the spread of resistance and safeguarding the future of patient care.
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