World Antimicrobial Resistance Awareness Week (WAAW) — observed annually from 18-24 Nov 2024 — underscores the escalating global threat of antimicrobial resistance (AMR). The overuse and misuse of antibiotics are reportedly the primary contributors to this issue.
In response, advanced oral hygiene-enhancing technologies such as light-activated therapy are emerging as preventive tools to manage oral health and reduce infections, aligning with efforts to curb AMR by decreasing reliance on antibiotics.
A study in The Lancet estimates that without decisive action, antibiotic resistance could result in 39 million deaths worldwide by 2050 — exceeding fatalities caused by cancer.
The drivers of AMR include over-prescription; misuse of antibiotics for non-bacterial illnesses; and the inappropriate use of broad-spectrum antibiotics, according to Prof Charlotta Edlund, a microbiologist at Sweden’s Public Health Agency. Drug shortages further compound the problem, often leading to reliance on less effective alternatives, which accelerate resistance.
The slow pace of antibiotic development exacerbates the crisis. “Scientific and economic challenges hinder the creation of new antibiotics, leaving us with limited tools to combat resistant infections,” she added.
Dentistry’s role in AMR
Dentistry contributes approximately 10% of global antibiotic prescriptions. These are often used to treat dental infections or as a preventive measure, but many are unnecessary, according to the World Dental Federation (FDI). Prof Edlund said that effective dental care should focus on addressing the root causes of infections through procedures like abscess drainage and endodontic treatments, with antibiotics reserved for systemic infections.
Comprehensive, evidence-based guidelines are crucial for improving antibiotic use in dentistry, but implementation requires ongoing education and monitoring to ensure adherence.
Innovative approaches
As resistance to traditional treatments grows, novel methods such as antibacterial photodynamic therapy (aPDT) are gaining traction.
Dr Tommi Pätilä, a cardiac and transplant surgeon in Helsinki, pointed out on the advantages of aPDT — which uses light-activated photosensitisers to generate reactive oxygen species (ROS) that destroy bacterial cells. This approach minimises the risk of resistance development, unlike conventional antibiotics.
aPDT is especially effective in dental care, being used to treat periodontal infections, sterilise root canals, and combat antibiotic-resistant bacteria. Dr Pätilä said, “Large-scale studies show no evidence of bacterial resistance to this treatment, making it a promising solution.”
The Lumoral system brings aPDT into home care, combining an antibacterial rinse with light-activated therapy. This dual-action method targets plaque bacteria, reducing oral infections like periodontitis and decreasing reliance on antibiotics. Unlike chemical antiseptics such as chlorhexidine (CHX), which can foster resistance, aPDT reportedly offers a safer alternative for long-term use.
Preventive dentistry: A path forward
Periodontal disease affects nearly half of the global population over 30, with severe cases linked to systemic health issues like heart disease and stroke. Prof Timo Sorsa of the University of Helsinki advocates for preventive care and early diagnosis to reduce these risks. “Plaque left behind by toothbrushing contributes to widespread oral health issues,” he said. “Innovative treatments like antibacterial aPDT enhance brushing’s effectiveness, reducing harmful bacteria and mitigating disease progression.”
Prof Sorsa also added that drug-free methods such as Lumoral align with global efforts to combat AMR. These approaches target harmful bacteria, reducing the need for antibiotics and antiseptics. He said, “Preventive dental care, combined with education and innovation, is crucial to tackling antibiotic resistance while improving public health outcomes.”
The role of education
To combat AMR, dental professionals worldwide must be equipped with the knowledge to use antibiotics judiciously. Antibiotics in periodontitis treatment should be reserved for severe cases, ensuring their efficacy for systemic infections.
WAAW serves as a reminder of the urgent need for global action and innovation in healthcare. By adopting advanced preventive methods and educating practitioners, the dental sector can play a pivotal role in combating antibiotic resistance, protecting both oral and systemic health.
