About the turn of the millennium, when I was early into my implant career and also providing lots of oral surgery and primary care under the NHS, I got transfixed by the work of someone called Mike Martin.
Mike Martin was a dental microbiologist who went around the country on a crusade based around the future risk of antimicrobial resistance.
He would lecture on objective facts of antimicrobial resistance and overprescribing by dentists, and I was absolutely convinced that his arguments were correct.
At the same time, there was guidance produced by the Royal College of Surgeons of England telling dentists and oral surgeons to stop prescribing antibiotics routinely for third molar surgery and so I decided at that time that this was one of the greatest things I could do in my practice, to reduce the risk of antimicrobial resistance and to benefit the populations as a whole.
Very early in the noughties, I stopped all antibiotic prescription for implant placement, apart from bone grafting procedures (the reason I carried on was I had two infections soon after stopping it for everything) and I've never routinely prescribed antibiotics for implant procedures for nearly 20 years.
I've managed to convince many people to take this line, particularly within our own practice, and we carefully monitor everything that we do here in relation to complications and implant failures and we know that we’re in the right place with this.
I'm delighted, with that in mind, that my friend and colleague and brilliant young implant surgeon, Beatriz Sanchez, has decided to make it one of her crusades, to look into antibiotic prescription in implant dentistry and to try and change people's views.
In order to do that, she's going to need some baseline numbers, just a pilot study really, just a sense of what people are doing.
We know that there are tonnes of guidance there, and different people are doing different things, some people doing nothing and some people giving ridiculous and crazy amounts of antibiotic prophylaxis for routine implant cases without bone grafting.
We understand what the Cochrane review says about this, but we'd like to have a look ourselves and then hopefully partner up with someone who has much more academic credibility than us to try to see if we can make a difference.
The first thing we're doing is anonymously surveying guys in implant dentistry about their antibiotic usage.
And so, if you have ever placed an implant at all and it doesn't matter how many, then I'd be really grateful if you would take a couple of minutes to fill out this survey.
I know that you're going to have masses of surveys to fill out everywhere and that it's a bore, and it's a nuisance to do it but I'm really asking for your help here because a tiny little drop in the ocean here could make a massive difference.
And once we have a sense of where everyone is, then we can realise what we're fighting against and how to make a difference going forwards.
For what it's worth, I believe we should never prescribe antibiotics in routine implant surgery unless a patient is significantly compromised medically (and then I wonder whether we should be doing at all) and I'm coming around to the circumstance of thinking that we might be able to avoid it, or at least most of it in bone grafting.
And so, watch this space because this is the type of legacy project which would make a difference rather than me just treating one patient at a time for my own benefit, moving forward until I stop at 50 (never going to happen unless I die).
Thanks a lot for your help.
The links here, it’s easy to fill out, and it's anonymous.
Blog Post Number - 3300