Assessment of drug-prescribing perception and practice among dental care providers: a cross-sectional Lebanese study

Main Article Content


Dentists, Prescription Drugs, Drug Prescriptions, Inappropriate Prescribing, Professional Practice, Counseling, Perception, Self Concept, Education, Dental, Continuing, Pharmacists, Interprofessional Relations, Cross-Sectional Studies, Lebanon


Background: Dentists play an essential role in providing high-quality dental care, taking into consideration the clinical context and concomitant medications taken by the patients.

Objective: This study aimed to assess drug-prescribing perception and practices in addition to drug-related educational needs among Lebanese dentists; it also evaluated the need for interprofessional collaboration between dentists and pharmacists.

Methods: An exploratory cross-sectional study using an online questionnaire targeted a sample of dentists from all Lebanese districts. Participants gave their consent by accepting to complete the survey (ethics approval reference: USJ-2016-63). The questionnaire consisted of closed-ended questions exploring: 1) drug-prescribing perception, 2) drug-prescribing practice, and 3) collaboration with pharmacists regarding their respective roles in providing appropriate counseling to patients. Two indexes were created: the first evaluated self-confidence in prescribing medications, and the second assessed dentists’ confidence in pharmacists. Logistic regressions were performed, taking each index as a dependent variable.

Results: A total of 137 dentists completed the survey (59% females; mean age: 42.17; SD: 13.78 years). The majority had a fair to good perceived knowledge in pharmacology and therapeutics (80.3%), only 30.7% reported to be sufficiently equipped to prescribe safely. Dentists exhibited particularly low perceived knowledge about prescribing in elderly patients, dosing, medication use in pregnancy, drug interactions, and adverse reactions. Dentists specialized in periodontics had the lowest odds of having self-confidence in prescribing drugs (aOR=0.25; p<0.001). Also, 64.3% declared that they routinely check a reference source before prescribing, and 78% relied on pharmaceutical companies and medical representatives to get information on medications. While 61% declared that pharmacists should provide oral care counseling, only half of them encouraged their patients to talk to their pharmacists about their medications. Only 15% considered that patients are getting enough counseling from the pharmacist, with a global confidence index below the median value, suggesting the need for more collaboration, especially with periodontists who exhibited the lowest confidence in pharmacists (aOR=0.45).

Conclusions: Lebanese dentists reported some lack of knowledge and confidence in prescribing practices. Education, training, and close collaboration between pharmacists and dentists are essential to overcome these problems and avoid potential harm to patients.


Download data is not yet available.
Abstract 452 | pdf Downloads 185


1. World Dental Federation (FDI), Evidence-based Dentistry (EBD). (accessed Feb 16, 2021).
2. Stewart A, Zborovancik KJ, Stiely KL. The impact of pharmacy services on opioid prescribing in dental practice. J Am Pharm Assoc (2003). 2017;57(2S):S78-S82.
3. Durkin MJ, Hsueh K, Sallah YH, et al. An evaluation of dental antibiotic prescribing practices in the United States. J Am Dent Assoc. 2017;148(12):878-886.e1.
4. Skaar DD, O'Connor H. Using the Beers criteria to identify potentially inappropriate medication use by older adult dental patients. J Am Dent Assoc. 2017;148(5):298-307.
5. Okunseri C, Zheng C, Steinmetz CN, Okunseri E, Szabo A. Trends and racial/ethnic disparities in antibiotic prescribing practices of dentists in the United States. J Public Health Dent. 2018;78(2):109-117.
6. Pon D, Awuah K, Curi D, Okyere E, Stern CS. Combating an Epidemic of Prescription Opioid Abuse. J Calif Dent Assoc. 2015;43(11):673-678.
7. Dana R, Azarpazhooh A, Laghapour N, Suda KJ, Okunseri C. Role of dentists in prescribing opioid analgesics and antibiotics: an overview. Dent Clin North Am. 2018;62(2):279-294.
8. American Dental Association. Statement on the use of opioids in the treatment of dental pain. (accessed Mar 27, 2020).
9. Blanco-Reina E, Valdellós J, Aguilar-Cano L, et al. 2015 Beers Criteria and STOPP v2 for detecting potentially inappropriate medication in community-dwelling older people: prevalence, profile, and risk factors. Eur J Clin Pharmacol. 2019;75(10):1459-1466.
10. de Andrade NK, Motta RHL, Bergamaschi CC, et al. Bleeding Risk in Patients Using Oral Anticoagulants Undergoing Surgical Procedures in Dentistry: A Systematic Review and Meta-Analysis. Front Pharmacol. 2019;10:866.
11. Fadlallah R, El-Jardali F. Improving the prescribing pattern and quality of pharmaceutical drugs in Lebanon. (accessed Feb 15, 2021).
12. Hajj A, Sacre H, Hallit S, Zeenny RM, Sili G, Salameh P. Prescription and dispensing guidelines in Lebanon: initiative of the Order of Pharmacists of Lebanon. J Pharm Policy Pract. 2020;13(1):70.
13. Mansour H, Feghali M, Saleh N, Zeitouny M. Knowledge, practice and attitudes regarding antibiotics use among Lebanese dentists. Pharm Pract (Granada). 2018;16(3):1272.
14. Asmar G, Cochelard D, Mokhbat J, Lemdani M, Haddadi A, Ayoubz F. Prophylactic and Therapeutic Antibiotic Patterns of Lebanese Dentists for the Management of Dentoalveolar Abscesses. J Contemp Dent Pract. 2016;17(6):425-433.
15. McEntee JE, Henderson SL, Rutter PM, Rutter J, Davis HJ, Randall CJ. A survey of UK dental health professionals using a medicines information service: what questions do they ask and do they get useful answers?. Br Dent J. 2011;211(1):17-21.
16. Jain A, Gupta D, Singh D, et al. Knowledge regarding prescription of drugs among dental students: A descriptive study. J Basic Clin Pharm. 2015;7(1):12-16.
17. Lieb K, Scheurich A. Contact between doctors and the pharmaceutical industry, their perceptions, and the effects on prescribing habits. PLoS One. 2014;9(10):e110130.
18. Teoh L, Stewart K, Marino RJ, McCullough MJ. Improvement of dental prescribing practices using education and a prescribing tool: A pilot intervention study. Br J Clin Pharmacol. 2021;87(1):152-162.
19. Teoh L, Marino RJ, Stewart K, McCullough MJ. A survey of prescribing practices by general dentists in Australia. BMC Oral Health. 2019;19(1):193.
20. Froum SJ, Weinberg MA. An Evaluation of Antibiotic Use in Periodontal and Implant Practices. Int J Periodontics Restorative Dent. 2015;35(4):481-487.
21. Gross AE, Hanna D, Rowan SA, Bleasdale SC, Suda KJ. Successful Implementation of an Antibiotic Stewardship Program in an Academic Dental Practice. Open Forum Infect Dis. 2019;6(3):ofz067.
22. Koyuncuoglu CZ, Aydin M, Kirmizi NI, et al. Rational use of medicine in dentistry: do dentists prescribe antibiotics in appropriate indications?. Eur J Clin Pharmacol. 2017;73(8):1027-1032.
23. Washington State Agency Medical Directors’ Group. Dental guideline on prescribing opioids for acute pain management. (accessed Sep 26, 2017).
24. Fink PB, Deyo RA, Hallvik SE, Hildebran C. Opioid Prescribing Patterns and Patient Outcomes by Prescriber Type in the Oregon Prescription Drug Monitoring Program. Pain Med. 2018;19(12):2481-2486.
25. Ministry of Public Health Lebanon (MOPH), Resolution 1/1054. (accessed Feb 17, 2021).
26. Tarhini F, Taky R, Jaffal L, et al. Awareness of Lebanese Pharmacists towards the Use and Misuse of Gabapentinoids and Tramadol: A Cross-sectional Survey. Dr Sulaiman Al Habib Medical Journal. 2020;2(1):24-30.
27. Skaar DD, O'Connor HL. Use of the Beers criteria to identify potentially inappropriate drug use by community-dwelling older dental patients. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012;113(6):714-721.
28. Beth-Tasdogan NH, Mayer B, Hussein H, Zolk O. Interventions for managing medication-related osteonecrosis of the jaw. Cochrane Database Syst Rev. 2017;10(10):CD012432.
29. Motta RHL, Bergamaschi CC, de Andrade NK, et al. Bleeding risk in patients using oral anticoagulants submitted to surgical procedures in dentistry: a systematic review protocol. BMJ Open. 2017;7(12):e019161.
30. Hajj A, Hallit S, Azzo C, et al. Assessment of knowledge, attitude and practice among community pharmacists towards dental care: A national cross sectional survey. Saudi Pharm J. 2019;27(4):475-483.
31. Eriksson AL, Wallerstedt SM. Developing confidence in basic prescribing skills during medical school: a longitudinal questionnaire study investigating the effects of a modified clinical pharmacology course. Eur J Clin Pharmacol. 2018;74(10):1343-1349.
32. Conway SE, Smith WJ, Truong TH, Shadid J. Interprofessional pharmacy observation activity for third-year dental students. J Dent Educ. 2014;78(9):1313-1318.

Most read articles by the same author(s)

1 2 3 > >>