# Antibiotic prophylaxis in dental implant surgery - A qualitative study on the attitudes and routines of Swedish dentists

## TL;DR

Swedish dentists have varied practices for using antibiotics before dental implant surgery due to unclear guidelines and the challenge of balancing infection prevention with antibiotic resistance.

## Contribution

The study reveals dentists' attitudes and the need for standardized guidelines to balance antibiotic use and patient safety.

## Key findings

- Dentists are aware of antibiotic resistance but prioritize immediate infection risks.
- Antibiotic prophylaxis practices vary based on patient factors and clinical experience.
- Clear, evidence-based guidelines are needed to reduce practice variability.

## Abstract

Antibiotic resistance is a critical global health challenge, necessitating judicious antibiotic use across all medical disciplines, including dentistry.

This qualitative study explored the attitudes and decision-making processes of Swedish dentists regarding antibiotic prophylaxis in dental implant surgery. A qualitative inductive research design was used to conduct semi-structured interviews with 17 dentists across Sweden. Purposive and snowball sampling ensured diverse perspectives.

Three key themes emerged: Perception of antibiotic resistance, Attitudes on antibiotic prophylaxis, and Need for clear guidelines. Participants demonstrated an awareness of antibiotic resistance as a significant public health concern but often perceived it as abstract compared to the immediate risks of postoperative infection. Their antibiotic prophylaxis practices varied widely, influenced by patient-specific factors, procedural complexity, and personal clinical experience. While some advocated selective use of antibiotic prophylaxis for high-risk cases, others routinely prescribe it to minimize complications, reflecting an ongoing tension between patient safety and antibiotic stewardship. A common frustration among dentists was the lack of evidence-based guidelines, which left decision-making subject to individual interpretation and contributed to practice variability. This underscores the need for standardized protocols that balance effective infection prevention with minimal antibiotic use.

This study shows that while dentists recognize the importance of addressing antibiotic resistance, this awareness often feels secondary to the immediate clinical risks of postoperative infections. Practice around antibiotic prophylaxis varies depending on individual clinical judgment, surgical protocol, patient factors, and the absence of clear, evidence-based guidelines. The study highlights the need for evidence-based guidelines that balance patient safety and antibiotic stewardship.

The online version contains supplementary material available at 10.1186/s12903-025-07064-1.