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Provider updates

New Guideline: Antibiotic use guideline for management of pulpal and periapical related dental pain and intraoral swelling.

Sep 17, 2021, 07:00 AM

Clinical guidelines are designed to support providers in their practice of dentistry. Dental departments or clinics may already have established clinical guidelines that help providers make decisions about treatment and standardize care. As a dental plan, CareOregon Dental also provides clinical guidelines on our website.

Evidence-based guidelines from reputable, professional resources are reviewed and approved by the CareOregon Dental quality committee. These practice guidelines:

  1. Are based on valid and reliable clinical evidence or a consensus of dental providers
  2. Consider the needs of our members
  3. Are adopted in consultation with you, our network providers
  4. Are reviewed and updated at least every two years to ensure they are current and still best practice
  5. Are provided to our provider network as part of our policy dissemination.

According to the CDC, dentists were responsible for 24.7 million antibiotic prescriptions in 2019, placing them within the top five provider specialties for outpatient antibiotic prescriptions. An estimated 80% of that prescribing is considered inappropriate, according to a 2020 article in JADA. Overuse in antibiotic prescribing leads to an increase in adverse reactions and the development of antibiotic resistant bacteria.

In 2019, American Dental Association published a clinical practice guideline to address this public health issue. Antibiotic use for the urgent management of pulpal-and-periapical-related dental pain and intraoral swelling supports antimicrobial stewardship by providing clinical recommendations for the management of symptomatic irreversible pulpitis with or without symptomatic apical periodontitis, pulpal necrosis with symptomatic apical periodontitis, and pulpal necrosis with localized acute apical abscess.

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