Dental consultations in UK general practice and antibiotic prescribing rates: a retrospective cohort study
Open accessAbstract
Background: The frequency of consulting for dental problems in general medical practice, and antibiotic prescribing associated with these consultations, is poorly described. Aim: To describe consultation rates and antibiotic use for dental problems in UK general medical practice, and explore factors associated with antibiotic prescribing for dental conditions. Design and setting: A retrospective cohort study using Clinical Practice Research Datalink, a database of general practice patient records in the UK. Method: All dental consultations between 2004 and 2013 were identified. The main outcome was the prescription of an antibiotic during a dental consultation. Multilevel logistic regression was conducted to examine factors associated with antibiotic prescription. Results: In all, 288 169 dental consultations were included in the cohort. The average rate of dental consultations was 6.06 consultations per 1000 patient-years. Rates of dental consultation decreased from 6.84 consultations per 1000 patient-years in 2008, to 4.23 consultations per 1000 patient-years in 2013. Consultation rates were higher among females than males and highest in patients aged 20–29 years. An antibiotic was prescribed in 57.1% of consultations. Significant predictors (P<0.001) of antibiotic prescribing included: patient middle age, male sex, and previous consultations for tooth-related problems. Antibiotics were more likely to be prescribed during consultations in December (odds ratio [OR] 1.18, 95% confidence interval [CI] = 1.13 to 1.24,P<0.001, reference month: June) and on a Monday (OR 1.10, 95% CI = 1.07 to 1.13,P<0.001) or a Friday (OR 1.15, 95% CI = 1.12 to 1.18,P<0.001, reference day: Wednesday). Conclusion: Consultation rates for dental problems in UK general practice are relatively low but more than half result in the prescription of an antibiotic. This raises concerns about patient morbidity and contributions to antimicrobial resistance.
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Problem-driven dental care leads to inappropriate and costly use of other services such as A&E and general medical practice.
“It is also well established that problem- driven dental care leads to inappropriate and costly use of other services such as A&E and general medical practice [8].”
From Economic Evaluation of the <scp>RETURN</scp> Intervention to Increase Routine Dental Attendance Among Disadvantaged Adults: Net Health Benefit ( <scp>QALYs</scp> ) and Patient Cost Outcomes From a Randomised Controlled Trial (2026) · cites this paper as [8]
The introduction says some patients consult a GP rather than a dentist for dental problems and that most such problems cannot be comprehensively managed in general practice. “How this fits in” says these consultations may substantially burden some practices. The paper does not establish that this use is costly, and “Comparison with existing literature” mentions increased A&E attendance only as a possible explanation for falling GP consultation rates, not as a demonstrated consequence of problem-driven dental care (page numbers unavailable). (LLM, conf=0.86)
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- Authors
- Cope, A. L., Chestnutt, I. G., Wood, F., & Francis, N. A.
- Affiliations
- Cardiff and Vale University Health Board (GB)
- Cardiff University (GB)
- Venue
- British Journal of General Practice
- Published
- 2016-03-29
- Volume
- 66
- Issue
- 646
- Pages
- e329-e336
- ISSN
- 0960-1643 (ISSN-L)
- 1478-5242
- PMC
- PMC4838445
- OpenAlex
- W2313312858
- Cited by
- 58
- References
- 23
- Citations by year
- 2026: 5 · 2025: 3 · 2024: 7 · 2023: 4 · 2022: 12 · 2021: 6 · 2020: 3 · 2019: 8 · 2018: 4 · 2017: 4 · 2016: 2
- FWCI
- 4.19
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- British Journal of General Practice (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- ePrints Soton (University of Southampton) (submittedVersion)
- ORCA Online Research @Cardiff (Cardiff University) (submittedVersion)
- Funders
- Cardiff University
- Topics
- Life Sciences › Immunology and Microbiology › Applied Microbiology and Biotechnology › Antibiotic Use and Resistance
- Health Sciences › Dentistry › Periodontics › Dental Health and Care Utilization
- Health Sciences › Health Professions › General Health Professions › Healthcare cost, quality, practices
- Keywords
- dental consultation, antibiotic prescribing, general practice, consultation rates, antimicrobial resistance, seasonal variation in prescribing, sex differences, age differences, primary care
- MeSH terms
- Anti-Bacterial Agents, Female, General Practice, Dental, United Kingdom, Health Services Accessibility, Humans, Male, Practice Patterns, Physicians', Primary Health Care, Referral and Consultation, Retrospective Studies, Socioeconomic Factors, Logistic Models, General Practice
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