Antimicrobial resistance stewardship in dental practice: a knowledge, attitudes, and practices study of dentist in Al-Ahsa, Saudi Arabia

Background: Antimicrobial resistance (AMR) poses a major public health challenge, with dentists contributing significantly through inappropriate prescribing. This study assessed the knowledge, attitudes, and practices (KAP) of dentists in Al-Ahsa, Saudi Arabia, regarding antibiotic use and AMR.

Methods: A cross-sectional survey was conducted over six months period among 424 licensed dentists working in public and private dental clinics in Al-Ahsa, Saudi Arabia. A clinic-bast, near census recruitment approach was used, and eligible dentist present during data collection period were invited to participate. Data were collected using structured, self-administered questionnaire distributed in google form. Content validity was established by three subject-matter experts, and internal consistency was confirmed using Cronbach’s α. KAP scores were derived from predefined item domains and categorized as poor (≤40%), fair (41–80%), or good (>80%). Descriptive statistics, Chi-squared test, and multinomial logistic regression analyses were applied.

Results: Among the 242 participants dentists were male 283 (66.75%) and general practitioners 271 (63.91%). Overall, 270 (63.7%) demonstrated poor knowledge, 187 (44.1%) exhibited fair attitudes, and 249 (58.7%) showed poor prescribing practices. While 361 (85.1%) acknowledged AMR as a global concern, misconceptions persisted regarding prophylactic use and first-line drug selection for penicillin-allergic patients. Continuing dental education (CDE) attendance and prescribing frequency were significant predictors of knowledge (P=0.03) and attitudes (P=0.008). Workload 195 (45.99%) and patient pressure influenced prescriptions in 227 (53.54%) of cases.

Conclusions: Dentists in Al-Ahsa displayed suboptimal knowledge and variable attitudes toward antibiotic use. Improving dental antibiotic stewardship may require strengthened, standardized CDE supported by system-level interventions (e.g., prescribing protocols and audit-feedback).