Original Article

Self-Declarative Performance of General Dentists in Prescribing Analgesics and Antibiotics for Patients Requiring Root Canal Treatment


Objectives: This study aimed to determine the self-declarative performance of general dentists in prescription of analgesics and antibiotics for patients requiring root canal treatment (RCT).
Materials and Methods: In this cross-sectional study, 400 general dentists participating in the 55th International Annual Scientific Congress of the Iranian Dental Association (2015) were randomly selected, and requested to complete a questionnaire about their performance regarding prescribing analgesics and antibiotics for patients requiring RCT. The frequency and percentage of answers to each question were calculated and reported.
Results: The most commonly prescribed analgesics included ibuprofen (100.0%), Gelofen (100.0%), Novafen (68.5%) and acetaminophen (24.8%). After RCT, dentists prescribed ibuprofen (100.0%), Gelofen (98.3%), dexamethasone (35.3%), Novafen (27.3%) and acetaminophen/codeine (15.8%) in decreasing order of frequency. Antibiotic prescription was minimum (48.5%) for cases with painful (moderate or severe) irreversible pulpitis (vital tooth) before the treatment and maximum for cases of pulp necrosis with acute apical periodontitis, edema, and preoperative symptoms (moderate or severe) (97.3%). For non-allergic patients, the most frequently prescribed antibiotics were amoxicillin 500 mg (93.3%), cefixime 400 mg (81.3%), amoxicillin/metronidazole 250 mg (71.8%), co-amoxiclav 265 mg (36.3%) and injectable penicillin (0.5%). For allergic patients, dentists prescribed clindamycin 300 mg (84.0%), cephalexin 500 mg (15.8%), azithromycin 500 mg (13.5%), and erythromycin 500 mg (10.8%). Sex and graduation date had no significant effect on the results (P>0.05).
Conclusion: Antibiotic prescription is excessive by general dentists, and their performance regarding the proper and logical prescription of antibiotics in RCT should be improved.

1. Palmer NO, Ahmed M, Grieveson B. An investigation of current endodontic practice and training needs in primary care in the north west of England. Br Dent J. 2009 Jun;206(11):584-5.
2. Harrison JW, Gaumgartner JC, Svec TA. Incidence of pain associated with clinical factors during and after root canal therapy. Part 1. Interappointment pain. J endod. 1983 Sep;9(9):384-7.
3. Bacsik CJ, Swift JQ, Hargreaves KM. Toxic systemic reactions of bupivacaine and etidocaine. Oral Surg, Oral Med, Oral Pathol, Oral Radiol Endod. 1995 Jan;79(1):18-23.
4. Lee M, Winkler J, Hartwell G, Stewart J, Caine R. Current trends in endodontic practice: emergency treatments and technological armamentarium. J endod. 2009 Jan;35(1):35-9.
5. Jaunay T, Sambrook P, Goss A. Antibiotic prescribing practices by South Australian general dental practitioners. Australian Dent J. 2000 Sep;45(3):179-86.
6. Demirbas F, Gjermo PE, Preus HR. Antibiotic prescribing practices among Norwegian dentists. Acta odontol Scand. 2006 Nov;64(6):355-9.
7. Nabavizadeh MR, Sahebi S, Nadian I. Antibiotic prescription for endodontic treatment: general dentist knowledge + practice in shiraz. Iranian endod J. 2011;6(2):54-9.
8. 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 Jul;8(7):Zc10-4.
9. Attar S, Bowles WR, Baisden MK, Hodges JS, McClanahan SB. Evaluation of pretreatment analgesia and endodontic treatment for postoperative endodontic pain. J Endod 2008 Jun;34(6):652-5.
10. Mainjot A, D'Hoore W, Vanheusden A, Van Nieuwenhuysen JP. Antibiotic prescribing in dental practice in Belgium. International endodontic journal. Int Endod J. 2009 Dec;42(12):1112-7.
11. Yingling NM, Byrne BE, Hartwell GR. Antibiotic use by members of the American Association of Endodontists in the year 2000: report of a national survey. J Endod. 2002 May;28(5):396-404.
12. Jayakodi H, Kailasam S, Kumaravadivel K, Thangavelu B, Mathew S. Clinical and pharmacological management of endodontic flare-up. J Pharm Bioallied Sci. 2012 Aug;4(Suppl 2):294-8.
13. Al-Maslamani MJ, Sedeqi FA, Moule AJ. Prescription pattern of antibiotic and analgesic in endodontic treatment in Kuwaiti population: A self-administered Survey. Saudi Endod J. 2014 Sep-Dec;4(3):128-34.
14. Fouad AF. Are antibiotics effective for endodontic pain?. Endod Topics. 2002 Nov;3(1):52-66.
15. Whitten BH, Gardiner DL, Jeansonne BG, Lemon RR. Current trends in endodontic treatment: report of a national survey. J Am Den Assoc. 1996 Sep;127(9):1333-41.
16. Slaus G, Bottenberg P. A survey of endodontic practice amongst Flemish dentists. Int Endod J. 2002 Sep;35(9):759-67.
17. Saatchi M, Arefi A, Navaei H. Antibiotic prescription pattern for endodontic treatment by general dental practitioners in Isfahan, Iran. Journal of Isfahan Dental School. 2012;8(5).
18. Rodriguez-Núñez A, Cisneros-Cabello R, Velasco-Ortega E, Llamas-Carreras JM, Tórres-Lagares D, Segura-Egea JJ. Antibiotic use by members of the Spanish Endodontic Society. J Endod. 2009 Sep;35(9):1198-203.
19. Segura‐Egea J, Velasco‐Ortega E, Torres‐Lagares D, Velasco‐Ponferrada M, Monsalve‐Guil L, Llamas‐Carreras J. Pattern of antibiotic prescription in the management of endodontic infections amongst Spanish oral surgeons. Int Endod J Apr. 2010;43(4):342-50.
20. Segura-Egea J, Gould K, Hakan Sen B, Jonasson P, Cotti E, Mazzoni A, et al. Antibiotics in endodontics: a review. Int Endod J. 2017 Dec;50:1169-84
21. Skucaite N, Peciuliene V, Vitkauskiene A, Machiulskiene V. Susceptibility of endodontic pathogens to antibiotics in patients with symptomatic apical periodontitis. J Endod. 2010 Oct;36(10):1611-6.
22. González-Martínez R, Cortell-Ballester I, Herráez-Vilas JM, Arnau-de Bolós JM, Gay-Escoda C. Antibiotic prescription in the treatment of odontogenic infection by health professionals: A factor to consensus. Med Oral Patol Oral Cir Bucal. 2012 May;17(3):e452.
23. Keenan JV, Farman AG, Fedorowicz Z, Newton JT. Antibiotic use for irreversible pulpitis. The Cochrane database Sys Rev. 2005 Apr;(2):Cd004969.
24. Henry M, Reader A, Beck M. Effect of penicillin on postoperative endodontic pain and swelling in symptomatic necrotic teeth. J Endod. 2001 Feb;27(2):117-23.
25. Newman MG, Winkelhoff A. Antibiotic and antimicrobial use in dental practice. 2001.
Anita Aminoshariae, ; James C. Kulild, Evidence-based recommendations for antibiotic usage to treat endodontic infections and pain A systematic review of randomized controlled trials. J Am Dent Assoc. 2016 Mar;147(3):186-191
26. Iqbal M, Kurtz E, Kohli M. Incidence and factors related to flare-ups in a graduate endodontic programme. Int Endod J. 2009 Feb;42(2):99-104.
27. Skucaite N, Peciuliene V, Maneliene R, Maciulskiene V. Antibiotic prescription for the treatment of endodontic pathology: a survey among Lithuanian dentists. Medicina. 2010 Dec;46(12):806-13.
28. Abbott PV. Selective and intelligent use of antibiotics in endodontics. Aust Endod J. 2000 Apr;26(1):30-9.
IssueVol 18 (Continuously Published Article-Based) QRcode
SectionOriginal Article
DOI https://doi.org/10.18502/fid.v18i13.6138
Analgesics Anti-Bacterial Agents Dentists Root Canal Therapy

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
Dibaji F, Yazdani R, Sajadi S, Mohamadi E, Mohammadian F, Kharazi Fard MJ. Self-Declarative Performance of General Dentists in Prescribing Analgesics and Antibiotics for Patients Requiring Root Canal Treatment. Front Dent. 2021;18.