Jenna Payesko

	Many times dentists are not aware that complications can develop from antibiotic use. 

Antibiotics prescribed by dentists may contribute to Clostridium difficile (C. diff) infections, suggests new research from the Minnesota Department of Health (MDH).

The MDH tracked community-associated C. diff infections in 5 counties of Minnesota, and throughout the 6-year period, determined 15% of those infected were prescribed antibiotics for dental procedures. One-third of the patients’ medical charts however, included no mention of receiving dental procedure-related antibiotics.

“Dentists have been overlooked as major partners in programs that promote appropriate antibiotic use,” Stacy Holzbauer, DVM, MPH, Minnesota Department of Health, said. “It’s critical that dentists are included in all efforts to improve antibiotic prescribing.”

MDH researchers interviewed 1,626 people with community-associated C. diff between 2009—2015 and of those, 926 (57%) reported they were prescribed antibiotics and 136 (15%) of those, for dental procedures.

“C. difficile is a known complication that accounts for more than 453,000 cases per year, causing an excess financial burden of more than $1 billion annually,” Holzbauer said. “Dentists need to be included in antibiotic stewardship programs. They’ve often been overlooked and it’s absolutely critical that they are included to improve prescribing across all modalities.”

The study found patients who were prescribed antibiotics for dental procedures tended to be older and more likely to receive clindamycin, an antibiotic associated with C. diff. Of those receiving antibiotics, 35% had no mention of antibiotics listed in medical charts, illustrating the disconnect between dental and medical care.

While the ADA expressed a commitment to and is an active partner in antibiotic stewardship, a 2015 MDH survey of dentists found fewer than half were concerned about adverse drug effects, antibiotic resistance or C. diff as factors influencing prescribing decision, which is likely attributed to the fact that prescribers are unaware when their patients develop C. diff.

“Many times dentists are not aware that complications can develop from antibiotic use. Better communication is needed between patients, dentists and medical providers,” she said.

Another survey previously conducted by MDH, demonstrated that 36% of dentists prescribed antibiotics in situations not recommended by the American Dental Association (ADA) and reported challenges to making appropriate antibiotic prescribing decisions including confusion about or perceived conflicts among prescribing guidelines.

While dentists appropriately prescribe antibiotics in certain situations such as for the treatment of infections stemming from a tooth abscess, some dentists prescribe antibiotics prophylactically before a dental procedure to prevent a heart infection in patients with heart conditions, or to prevent an infection of an artificial joint. The ADA no longer recommends preventive antibiotics in most of the cases.

Current recommendations note the risk of antibiotics is greater than the risk of infection, however inappropriate use of antibiotics helps fuel drug-resistant bacteria.

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Current ADA recommendations note the risk of antibiotics is greater than the risk of infection, however inappropriate use of antibiotics helps fuel drug-resistant bacteria.


Dental Procedure Antibiotics Link to Clostridium difficile

These destinations have a lot to offer for travelers on a short timeline.

After a long week, sometimes a weekend getaway is in order. Deciding on a travel destination can be daunting, especially when you only have a few days to spare.

We sought out some of the top destinations for much needed R&R, from California’s majestic redwoods to New England’s hotspots. Here are a few serene destinations perfect for cooler weather.

Boston is the destination for crisp weather, history and excitement in the fall. Travel across the Charles River to explore Cambridge and sit in Harvard Yard for people watching opportunities, then recharge in one of the various coffee shops. If you can, catch a game at the historic Fenway Park. The city is filled with amazing music venues like The Middle East, so be sure to check out the options.

If you want to spend a weekend like the locals, try the Pearl Farmers Market or tube down the Guadalupe River. If you’re adventurous, make time to visit the underground Natural Bridge Caverns. You can’t go wrong with a stroll or cruise along the famous River Walk tucked just below street level. Here you’ll find some of the city’s best restaurants, shops and galleries, all steps away from The Alamo.

With a moderate climate and otherworldly terrain, Sedona is full of surprises. It’s considered a spiritual mecca, and the many spiritual gift shops offer travelers the chance to have their aura read. If you’re adventurous, take a jeep tour high into the red rocks where you’ll have the opportunity to see incredible sights.

A jewel of the Pacific Northwest offers iconic sights like Pike Place Market, the original Starbucks and the Space Needle. Remember to bring along an umbrella and raincoat as the Emerald City’s weather can be slightly unpredictable.

If you’re in the mood for a scenic wine tour to kick off fall, skip Napa and head to Walla Walla — a new destination for wine connoisseurs. Home to more than 100 wineries, the region was also named Friendliest Small Town by USA Today and Rand McNally. Indulge in wine tasting and live music at Maryhill Winery, surrounded by breathtaking scenery.

There’s never a bad time to visit Savannah, Georgia, and if you head 30 minutes east to the shore, you’ll find the secret treasure of Tybee Island. Those on the island in October can experience the annual Pirate Fest, when the island transforms into a pirate village. Climb to the top of Tybee Lighthouse and watch the sunset over the water.

Interested in a calm, cozy getaway this fall? Highlands proves an excellent option, filled with hiking, scenic views and plenty of modern amenities. This rustic yet refined mountain town — just three hours from the hustle and bustle of Atlanta and four hours from Charlotte &mdash;  is known for its R&R. Its downtown and surrounding countryside is filled with fine art galleries, white-tablecloth restaurants and the most scenic fall color spots.

Charleston offers Spanish moss-laden bed and breakfasts and gas lamp-lit cobblestone streets, transporting you to a simpler time. Spend the weekend strolling along The Battery, indulging in southern food or browsing Old City Market. It’s full of great food, beautiful historic homes and a lively atmosphere. Stay at the Belmond Charleston Place or the Planters Inn for impeccable service.

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Once the craziness of summer has come and gone, the excitement for all things fall begins, carrying into the cooler weather. But just because the seasons are changing, that doesn't mean you can't squeeze in a mini vacation. We compiled the most scenic places that you can enjoy in just 48 hours. 
