Antibiotics and antifungals save lives, but their use can cause side effects and lead to antimicrobial-resistant infections. Antimicrobial resistance has the potential to impact people at any stage of life and the healthcare, veterinary, and agriculture industries, making it one of the world’s most urgent public health problems.
Antimicrobial resistance occurs when bacteria, viruses, fungi, and parasites change over time and no longer respond to medication, making infections harder to treat and increasing the risk of disease spread, severe illness, and death. The global burden associated with drug-resistant infections is enormous, making it among the leading causes of death worldwide.
In 2021, 7.7 million people worldwide died from bacterial infections, with drug resistance contributing to 4.71 million of these deaths and directly causing 1.14 million deaths.1 In the U.S., more than 2.8 million antimicrobial-resistant infections occur each year, and more than 35,000 people die as a result.2 When C. diff is factored in, the U.S. toll exceeds 3 million infections and 48,000 deaths. The estimated cost to treat infections caused by 6 common antimicrobial-resistant germs is staggering at greater than $4.6 billion annually.3
Antimicrobial resistance continues to be a concern in dentistry. Antibiotics are routinely prescribed to treat acute and chronic infections, support periodontal treatment, and provide prophylaxis before invasive procedures.4 Only about 12% of dentists fully adhere to prescribing guidelines. A recent study found that 80.9% of antibiotic prophylaxis prescriptions were unnecessary.5
Several key pathogens have become more resistant, with some strains developing resistance to amoxicillin and penicillin. When once-effective common antibiotics fail, dentists turn to second-line options, which can accelerate the resistance trends.6 Broader-spectrum agents, such as Augmentin or clindamycin, are frequently used despite narrower-spectrum agents being adequate.4
Dentists, therefore, play a role and must ensure that current evidence-based guidelines are followed, including:
- prescribing antibiotics only when medically appropriate;
- minimizing misdiagnoses or delayed diagnoses, which can lead to the more efficient use of antibiotics; and
- ensuring that the right drug, dose, and duration are selected when an antibiotic is needed.
To help our network providers understand the critical nature of antimicrobial resistance in the dental ecosystem, Cigna Dental is partnering with the International College of Dentists (ICD) to share its vast library of resources on the topic, including continuing education opportunities, articles, and media resources collected from numerous national and internal subject matter experts.
These resources may be found at: Understanding Antimicrobial Resistance – International College of Dentists (icd.org)
References
- Global antibiotic resistance surveillance report 2025
- Antimicrobial Resistance Facts and Stats | Antimicrobial Resistance | CDC
- National Estimates of Healthcare Costs Associated With Multidrug-Resistant Bacterial Infections Among Hospitalized Patients in the United States | Clinical Infectious Diseases | Oxford Academic
- Antibiotic Resistance in Dentistry: A Review | MDPI
- Assessment of the Appropriateness of Antibiotic Prescriptions for Infection Prophylaxis Before Dental Procedures, 2011 to 2015 | Infectious Diseases | JAMA Network Open | JAMA Network
- Antimicrobial Resistance in Oral Healthcare: A Growing Concern in Dentistry