Antimicrobial Resistance: A Dentists’ Prospective

Abstract

Antimicrobial resistance has turned from prediction to reality in a few decades and exerts a significant
burden globally with a loss of approximately seventy thousand lives each year. Dentistry accounts for
approximately three to eleven percent of all antibiotic prescriptions worldwide. The human oral cavity is a
huge reservoir of more than 750 microbial species. Oral microbial biofilm formation such as dental plaque
that initiates periodontal diseases and dental caries is the major reason for the antimicrobial therapy failure
and rise in resistance against the action of antimicrobials. Biofilm bacteria embedded with a matrix of
extracellular polysaccharides are more than 10,000 times less sensitive to antimicrobials than free-floating
planktonic bacteria. A thorough understanding of the mechanism will provide an effective solution to
combat the current problem such as developing novel antimicrobials, method that enhance the effectiveness
of antibiotics by modifying the antibiotic structure or disrupting biofilm, or altering the outer membrane
structure of bacterial cell walls to neutralize the resistant enzymes. Use of novel strategies e.g. nano-drug
delivery system to facilitate drug entry into the cell; liposome for efficient local delivery of drug of choice
in the treatment of caries, periodontitis and also for anesthetic purposes. This paper provides a review of the
literature based on the studies on oral biofilm, its formation, and importance in drug resistance, mechanism
of drug action and development of its drug resistance and various measures to combat it and the scope of
dentists in limiting the progression of antibiotic resistance.