The American Dental Association has received a five-year cooperative agreement from the Centers for Disease Control and Prevention to develop evidence-based antibiotic prescribing guidance for dentists, along with new safety guidance for the human tissue grafts used in many surgical procedures. ADA News reported the award on Nov. 12.

The agreement comes through the CDC's Division of Healthcare Quality Promotion. ADA News did not report a dollar amount or say when the first guidance documents are expected.

On the antibiotic side, the ADA says the funding will support prescribing guidance and practical resources to help dental offices use health information technology to strengthen their stewardship. In plain terms, that means tools to help practices see how often and why they prescribe, not just a new set of rules.

The problem is well documented. Dentists account for roughly 10% of all antibiotic prescriptions written in the United States, according to CDC figures cited by Decisions in Dentistry, and published research in The Journal of the American Dental Association has estimated that 80% to 90% of those prescriptions may be unnecessary.

The grant follows an ADA clinical practice statement published in the October issue of JADA, which urged the profession to move away from a "just-in-case approach" to prescribing and toward an "evidence-based, when absolutely needed model."

The second half of the agreement covers human tissue allografts, which dentists use in periodontal regeneration, oral reconstruction and implant site development, as well as socket preservation and sinus lifts. Donor tissue is screened and tested before it reaches a practice, but Decisions in Dentistry notes that a residual risk of viral, bacterial and fungal infection, and of prion disease, remains.

The ADA plans to produce evidence-based guidance on allograft safety, standards for clinical documentation and informed consent, a framework for tracing graft products through health information technology, and education for dental professionals.

"Our commitment as oral healthcare professionals is to do no harm," ADA President Thomas Paumier, D.D.S., said in the announcement. He described responsible antibiotic stewardship and a stronger understanding of the safe use of human tissue as critical to patient safety and public health, adding that "collaboration is essential to advancing public health and improving patient outcomes."

The ADA said it will work with the CDC and experts in related fields on both efforts.

Nothing changes in the operatory yet. The work runs over five years, and no timeline has been given for the prescribing guideline.

Still, the direction is clear. Prophylactic and "just in case" prescriptions are likely to face more scrutiny, and offices that already review their own prescribing patterns will be ahead when the guidance lands. Practices that place bone or soft tissue grafts should expect clearer expectations around recording which product went into which patient and what that patient was told beforehand. Periodontists, oral surgeons and general dentists who do their own grafting may want to look at how their charting and consent forms handle allografts today.

Sources: ADA News, Decisions in Dentistry