AMR public health research priorities for oral health in Africa: evidence gaps and pathways for action
1
Community Dentistry, University of the Western Cape, Cape Town, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):A216
ABSTRACT
INTRODUCTION:
Dentistry accounts for an estimated 10% of global antibiotic use, with misuse and inappropriate prescribing reported in up to 90% of cases in several countries, including many in Africa.1-2 Africa bears a high burden of oral diseases (approximately 42%), combined with a severe shortage of oral health workers (3.7 per 100 000 population).3 As a result, oral pain and infection are frequently managed by non-dentists or through self-medication, increasing the risk of antimicrobial misuse. Key drivers of antimicrobial resistance (AMR) in dentistry include defensive and prophylactic prescribing, lack of adherence to clinical guidelines, limited access to diagnostics, and weak stewardship and surveillance systems.4 While the WHO has identified 40 global AMR research priorities5, many of which focus on low- and middle-income countries6, oral health remains largely absent from this agenda.7-11
METHODS:
This analysis maps oral health–related AMR challenges in Africa against the WHO global AMR research priority framework across prevention, diagnosis, treatment, stewardship, and cross-cutting domains. We identify gaps where oral health is directly implicated but insufficiently addressed in current AMR research and policy.
RESULTS:
Key gaps aligned with WHO AMR priorities include: (1) prevention—limited evidence on the role of water, sanitation and hygiene (WASH) and infection prevention and control (IPC) in reducing dental antibiotic use; (2) diagnosis—lack of feasible, point-of-care tools to distinguish bacterial from non-bacterial oral infections; (3) treatment and stewardship—absence of context-specific stewardship interventions addressing prescribing behaviours in dental and non-dental care settings; and (4) cross-cutting gaps—weak AMR surveillance systems that exclude oral health data.
CONCLUSIONS:
Oral health is a missing component of Africa’s AMR response. Addressing this gap requires prioritising African-generated evidence on antibiotic prescribing, stewardship strategies, and resistance patterns, and integrating oral health into national AMR surveillance and action plans.
Dentistry accounts for an estimated 10% of global antibiotic use, with misuse and inappropriate prescribing reported in up to 90% of cases in several countries, including many in Africa.1-2 Africa bears a high burden of oral diseases (approximately 42%), combined with a severe shortage of oral health workers (3.7 per 100 000 population).3 As a result, oral pain and infection are frequently managed by non-dentists or through self-medication, increasing the risk of antimicrobial misuse. Key drivers of antimicrobial resistance (AMR) in dentistry include defensive and prophylactic prescribing, lack of adherence to clinical guidelines, limited access to diagnostics, and weak stewardship and surveillance systems.4 While the WHO has identified 40 global AMR research priorities5, many of which focus on low- and middle-income countries6, oral health remains largely absent from this agenda.7-11
METHODS:
This analysis maps oral health–related AMR challenges in Africa against the WHO global AMR research priority framework across prevention, diagnosis, treatment, stewardship, and cross-cutting domains. We identify gaps where oral health is directly implicated but insufficiently addressed in current AMR research and policy.
RESULTS:
Key gaps aligned with WHO AMR priorities include: (1) prevention—limited evidence on the role of water, sanitation and hygiene (WASH) and infection prevention and control (IPC) in reducing dental antibiotic use; (2) diagnosis—lack of feasible, point-of-care tools to distinguish bacterial from non-bacterial oral infections; (3) treatment and stewardship—absence of context-specific stewardship interventions addressing prescribing behaviours in dental and non-dental care settings; and (4) cross-cutting gaps—weak AMR surveillance systems that exclude oral health data.
CONCLUSIONS:
Oral health is a missing component of Africa’s AMR response. Addressing this gap requires prioritising African-generated evidence on antibiotic prescribing, stewardship strategies, and resistance patterns, and integrating oral health into national AMR surveillance and action plans.
| eISSN: | 2654-1459 |
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