Dental antimicrobial stewardship: toolkit

Resources to help primary care practitioners promote the appropriate use of antibiotics in dental care.

The dental antimicrobial stewardship (AMS) toolkit for primary care was developed in collaboration between the Dental Subgroup of Public Health England’s English surveillance programme for antimicrobial utilisation and resistance (ESPAUR), Faculty of General Dental Practice (FGDP) and British Dental Association (BDA).

The toolkit is based on work originally developed by NHS England Cheshire and Merseyside Local Dental Network.

The toolkit



Education and training tools

Audit tool and action planning

An audit tool developed as a collaboration between FGDP, BDA and Public Health England (PHE) is available from:

Why the toolkit was developed

The inappropriate use of antibiotics is related to bacterial resistance. Responsible use of antimicrobials should help control it. The toolkit aims to influence prescribers and patients attitudes to enable optimal antibiotic prescribing.

An independent review of antimicrobial resistance, the Antimicrobial Resistance (AMR) Review commissioned by the UK Government in 2014 and chaired by Lord Jim O’Neill, analysed the global impact and estimates that a failure to address the problem of antibiotic resistance could result in:

  • 10 million deaths every year globally by 2050
  • a cost of £66 trillion ($100 trillion) to the global economy

In March 2013, Professor Dame Sally Davies, Chief Medical Officer said:

Antimicrobial resistance poses a catastrophic threat. If we don’t act now, any one of us could go into hospital in 20 years for minor surgery and die because of an ordinary infection that can’t be treated by antibiotics.

Using the resources in the Dental AMS toolkit can contribute to dental surgeries and practitioners demonstrating compliance with the Health and Social Care Act 2008: Code of Practice on the prevention and control of infections and related guidance.

The toolkit also supports recommendations made in the NICE guideline NG15 Antimicrobial stewardship: systems and processes for effective antimicrobial medicine use.

The Dental Subgroup

The Dental Subgroup of ESPAUR was established in 2015, with the aim of exploring surveillance, and improving stewardship through prevention, development of resources, audit and education in the dental sector.

The objectives of the group are to:

  • develop a collaborative action plan with partners describing roles, responsibilities and time frames
  • improve data granularity of dental antimicrobial prescribing in primary care
  • improve antimicrobial stewardship (AMS) in primary care dental practice through the development of resources and audit
  • promote initiatives to improve patient awareness of appropriate use of antibiotics for dental infections
  • promote initiatives to improve good oral health in order to prevent infections before they arise

The subgroup includes multi-organisation representation including:

  • PHE
  • FGDP
  • BDA
  • Association of Clinical Oral Microbiologists
  • Faculty of Dental Surgeons Royal College of Surgeons England
  • Health and Social Care Information Centre
  • NHS Business Services Authority
  • NHS England
  • NHS Improvement
  • Health Education England
  • Council of Dental School Deans
  • British Association for the Study of Community Dentistry
  • Denplan
  • Prescribing adviser, clinical commissioning group
Published 9 November 2016
Last updated 3 June 2020 + show all updates
  1. Added link to drama video about antibiotic prescribing.

  2. Added links to antimicrobial stewardship e-modules and guidance on antibiotic prophylaxis against infective endocarditis and drug prescribing for dentistry.

  3. Added adult and child pain relief poster.

  4. Added 'Delivering better oral health: an evidence based toolkit for prevention' under guidance.

  5. First published.