Utilisation and Shortages of Dental Medicines in Australia From 2014 to 2025: A Retrospective Time-Series Study.

Abstract

Background: Dental prescribing in Australia under the Pharmaceutical Benefits Scheme (PBS) has evolved alongside antimicrobial stewardship initiatives, opioid regulation, and medicine shortages. Understanding national utilisation trends is important to inform policy and safe prescribing practices.

Methods: A retrospective analysis of publicly available PBS and Repatriation PBS (RPBS) Section 85 and Section 100 Date of Supply data was conducted from February 2014 to August 2025. Dental schedule item codes were identified via the PBS Publications Archive. Monthly dispensing rates per 100,000 population were calculated using Australian Bureau of Statistics population estimates. Medicines were classified by Anatomical Therapeutic Chemical (ATC) classification third level code, with trends assessed by therapeutic class and formulation. Therapeutic Goods Administration (TGA) shortage reports were used to contextualise utilisation changes.

Results: Fifty-nine dental medicines were included in the PBS dental schedule during the study period, with 50 remaining in August 2025. Antibiotics were commonly utilised, with amoxicillin 500 mg capsules consistently most dispensed. Paracetamol with codeine remained the second most dispensed medicine despite regulatory changes. Amoxicillin with clavulanic acid use increased, while clindamycin declined except during metronidazole shortages. Oxycodone dispensing rose markedly from 2023, whereas ibuprofen use declined.

Conclusions: Dental medicine utilisation shifted over time, likely reflecting stewardship efforts and supply disruptions. Ongoing review of the PBS Dental Schedule is warranted to ensure alignment with contemporary clinical guidance and optimise safe prescribing.