Home Browse Systematic review protocol on antibiotic use for orofacial pain: Policy...
ALL Metrics
-
Views
-
Downloads
Get PDF
Get XML
Cite
Export
Track
▬
✚
Study Protocol

Systematic review protocol on antibiotic use for orofacial pain: Policy and practice implications

[version 1; peer review: 1 approved, 1 approved with reservations]
Nishant Mehta
https://orcid.org/0000-0001-6273-4892
1, Richa Shrivastava2, Neha Patyal
https://orcid.org/0000-0002-6115-8878
3, Arpit Gupta
https://orcid.org/0000-0002-6115-8878
4
Nishant Mehta
https://orcid.org/0000-0001-6273-4892
1, Richa Shrivastava2, Neha Patyal
https://orcid.org/0000-0002-6115-8878
3, Arpit Gupta
https://orcid.org/0000-0002-6115-8878
4
PUBLISHED 08 Apr 2025
Author details Author details
OPEN PEER REVIEW
REVIEWER STATUS

This article is included in the Antimicrobial Resistance collection.

Abstract

Background

Dental pain and intraoral swelling, commonly resulting from pulpal and periapical infections, are leading causes of emergency visits. Overuse of antibiotics in such cases contributes to antimicrobial resistance. The appropriateness of antibiotic use must be evaluated to ensure rational prescribing and minimize unnecessary prescriptions.

Objectives

This review aims to evaluate the effectiveness and associated signs and symptoms of empiric antibiotic treatment for ≤5 days compared to >5 days in patients presenting with dental pain.

Methods

This protocol has been conducted following PRISMA-P guidelines. A comprehensive search of four electronic databases, such as PubMed, Scopus, Cochrane and Embase was performed to find pertinent studies. This study will follow PICOS framework, including individuals receiving antibiotic treatment for oro-facial pain. Randomized controlled trials evaluating the use of empirical antibiotics for <5 days, compared to >5 days for dental pain management. Outcomes assessed will be pain reduction, quality of life improvement, adverse events related to antibiotic, clinical resolution, microbiological and radiological findings, biomarkers, antimicrobial resistance, cost implications. Independent reviewers will screen the studies, assess the risk of bias by using RoB-2 and certainty of evidence by using GRADE. Where feasible, a meta-analysis will be conducted to synthesize findings and provide a quantitative summary of the results.

Results

The study commenced in February 2025 and is anticipated to be completed by May 2025.

Conclusions

This review will evaluate the effectiveness of antibiotic prescriptions for dental pain, minimizing adverse effects and identifying guideline adherence gaps. Findings will support antibiotic stewardship and inform policies to promote rational use, aiming to curb antimicrobial resistance while ensuring effective, evidence-based pain management in dental practice.

Keywords

Orofacial Pain, Antimicrobial resistance, antimicrobial, practice guidelines, clinical decision making

Corresponding author: Arpit Gupta
Competing interests: No competing interests were disclosed.
Grant information: This research is supported by funding from the Department of Health Research, Ministry of Health and Family Welfare, Government of India [Grant number:-
EM-Del/Centreforguidelines/DHR/2024].
The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Copyright:  © 2025 Mehta N et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
How to cite: Mehta N, Shrivastava R, Patyal N and Gupta A. Systematic review protocol on antibiotic use for orofacial pain: Policy and practice implications [version 1; peer review: 1 approved, 1 approved with reservations]. F1000Research 2025, 14:415 (https://doi.org/10.12688/f1000research.163353.1) First published: 08 Apr 2025, 14:415 (https://doi.org/10.12688/f1000research.163353.1) Latest published: 22 Jul 2025, 14:415 (https://doi.org/10.12688/f1000research.163353.2)

Introduction

The global burden of dental pain significantly impacts individuals’ quality of life and can lead to costly healthcare interventions.1 Dental pain and intraoral swelling are among the most common reasons why patients seek emergency care.2 Dentists are among the leading antibiotic prescribers globally, contributing significantly to outpatient prescriptions.3 International data indicate that dentists contribute approximately 7–10% of antibiotic prescriptions in primary care.4 Antibiotics play a crucial role in managing systemic infections and preventing complications in high-risk patients, their routine use in dental pain management remains a contentious issue.5 Antibiotic prophylaxis in dentistry helps prevent complications like dry sockets and infections, especially in high-risk patients. However, routine post-extraction antibiotic use is debated. Some argue that it aids healing and prevents infections, while others believe natural defenses suffice, even after surgery.6 Although, While certain oro-facial infections may necessitate empirical antibiotic administration, dentists frequently prescribe antibiotics for pain management as well.7–10

The overuse and misuse of antibiotics contribute significantly to antimicrobial resistance (AMR), a growing global health crisis.11 Evidence suggests that 30% to 85% of dental antibiotic prescriptions may be unnecessary or suboptimal, raising concerns about AMR and antibiotic stewardship.12–14 The World Health Organization (WHO) identifies AMR and antibiotic misuse as major global public health threats, contributing to over 6.5 million deaths annually.15

Several systematic reviews and clinical guidelines outline the indications and efficacy of antibiotics for odontogenic infections.16–20 The American Dental Association (ADA) has released guidelines on the antibiotics use for managing dental pain and swellings related to endodontic infections.7 These evidence-based guidelines from the American Dental Association (ADA) emphasize that antibiotics should be reserved for cases involving systemic involvement and that immediate definitive conservative dental treatment should be prioritized.7 However, due to scarcity of the systematic evidence evaluating the effectiveness of antibiotics in managing oro-facial pain. Moreover, despite existing recommendations, there is no consensus on the optimal duration of antibiotic therapy for dental infections. Some studies suggest that shorter courses (≤5 days) may be as effective as longer courses (>5 days) in achieving clinical resolution while reducing the risk of resistance, adverse effects, and healthcare costs.21

Moreover, several studies highlight high prescription rates among dental professionals, often driven by empirical treatment rather than clinical necessity.22–26 The inappropriate use of antibiotics for conditions that do not require them contributes to increased resistance, unnecessary side effects, financial burdens, and potential long-term health risks.5Therefore, the concept of “Rational Use of Drugs” emphasizes that medications should be prescribed based on clinical necessity, effectiveness, and cost-effectiveness.26 However, there is insufficient evidence in dentistry to substantiate this approach. Addressing these issues require the development of evidence-based guidelines tailored to the dental profession and improved adherence to rational prescribing practices. Given the global urgency to combat AMR and improve antibiotic prescribing practices, this review aims to assess the effectiveness of short-duration (≤5 days) versus long-duration (>5 days) antibiotic therapy in patients presenting with oro-facial pain.

Materials

Design and registration of protocol

The protocol follows the PRISMA-P (Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Protocols) guidelines.27 PRISMA-P guidelines ensure transparency and rigor in systematic review protocols by outlining key components like objectives, search strategy, and bias assessment. They enhance clarity, minimize bias, and improve reproducibility. Using PRISMA-P helps standardize reporting, facilitating peer review and evidence-based decision-making while reducing methodological deviations. Prospective registration of the study protocol was made in PROSPERO; CRD420250610118.28 This systematic review will answer the following research question: ‘In patients presenting with dental pain, is empiric antibiotic treatment for less than or equal to 5 days as effective as antibiotic treatment for more than 5 days?

Eligibility criteria

The selection of studies for this systematic review will be guided by PICOS framework (Population, Intervention, Comparison, Outcome, and Study Design), detailed as follows:

Population: Individuals receiving empirical antibiotic treatment for dental pain.

Intervention: Empirical antibiotics for a shorter duration (< 5 days).

Comparison: Empirical antibiotics for a longer duration (>5 days).

Outcomes: The primary outcomes of the study include the reduction in pain, improvement in quality of life, and assessment of adverse events associated with antibiotic use. Secondary outcomes are clinical resolution of other signs and symptoms, improvement in diagnostic parameters like microbiological tests, radiological findings, relevant biomarkers, reduction in complications, reduction in development of antibiotic resistance, cost considerations.

Study design: Randomized controlled trials (RCTs) will be considered eligible. Non-randomized trials, observational studies, case reports, qualitative studies, mixed-method studies, pre-post intervention studies with or without comparators, narrative/systematic reviews, and letters to the editor will be excluded.

Information sources and systematic search strategy

A systematic search was conducted to determine the relevant studies published in English across four electronic databases, such as PubMed, Scopus, Cochrane Library (CENTRAL) and Embase. The search strategy utilized a blend of Medical Subject Headings (MeSH) terms, primary keywords, and standardized vocabulary, integrating the following terms: ((“dental,” “teeth,” “orofacial,” “Temporomandibular,”) AND (“pain,” “ache,” “toothache,” “analges*”) AND (“antimicrobial,” “antibiotic”)). The vocabulary, search syntax, and study design filters were tailored and adapted to each database accordingly. The systematic search was conducted between February 1, 2025 and February 16, 2025 and was independently reviewed and cross-verified by the investigators. Detailed search strategies for each database are provided in Table 1. Hand search was performed to identify relevant grey literature from Google Scholar, references of selected studies and previous systematic reviews.

Table 1. Search strategy.

Search engineSearch string
PubMed(“dental health services”[MeSH Terms] OR (“dental”[All Fields] AND “health”[All Fields] AND “services”[All Fields]) OR “dental health services“[All Fields] OR “dental“[All Fields] OR “dentally“[All Fields] OR “dentals“[All Fields] OR (“teeth s“[All Fields] OR “teeths“[All Fields] OR “tooth“[MeSH Terms] OR “tooth“[All Fields] OR “teeth“[All Fields] OR “tooth s“[All Fields] OR “tooths“[All Fields]) OR (“teeth s“[All Fields] OR “teeths“[All Fields] OR “tooth“[MeSH Terms] OR “tooth“[All Fields] OR “teeth“[All Fields] OR “tooth s“[All Fields] OR “tooths“[All Fields]) OR “orofacial“[All Fields] OR “Temporomandibular“[All Fields]) AND (“pain“[MeSH Terms] OR “pain“[All Fields] OR (“pain“[MeSH Terms] OR “pain“[All Fields] OR “ache“[All Fields]) OR (“toothache“[MeSH Terms] OR “toothache“[All Fields] OR “odontalgia“[All Fields] OR “odontalgias“[All Fields] OR “toothaches“[All Fields]) OR “analges*“[All Fields]) AND (“anti infective agents“[Pharmacological Action] OR “anti infective agents“[MeSH Terms] OR (“anti infective“[All Fields] AND “agents“[All Fields]) OR “anti infective agents“[All Fields] OR “antimicrobial“[All Fields] OR “antimicrobials“[All Fields] OR “antimicrobially“[All Fields] OR (“anti bacterial agents“[Pharmacological Action] OR “anti bacterial agents“[MeSH Terms] OR (“anti bacterial“[All Fields] AND “agents“[All Fields]) OR “anti bacterial agents“[All Fields] OR “antibiotic“[All Fields] OR “antibiotics“[All Fields] OR “antibiotic s“[All Fields] OR “antibiotical“[All Fields]))
Embase(antimicrobial:ti,ab,kw OR antibiotic:ti,ab,kw) AND (dental:ti,ab,kw OR tooth:ti,ab,kw OR teeth:ti,ab,kw OR orofacial:ti,ab,kw OR temporomandibular:ti,ab,kw) AND (pain:ti,ab,kw OR ache:ti,ab,kw OR toothache:ti,ab,kw OR analges*:ti,ab,kw)
Scopus((title-abs-key (dental) OR title-abs-key (tooth) OR title-abs-key (teeth) OR title-abs-key (orofacial) OR title-abs-key (temporomandibular))) AND ((title-abs-key (pain) OR title-abs-key (ache) OR title-abs-key (toothache) OR title-abs-key (analges*))) AND ((title-abs-key (antimicrobial) OR title-abs-key (antibiotic)))
Cochrane Central(dental):ti,ab,kw OR (tooth):ti,ab,kw OR (teeth):ti,ab,kw OR (orofacial):ti,ab,kw OR (temporomandibular):ti,ab,kw AND (pain):ti,ab,kw OR (ache):ti,ab,kw OR (toothache):ti,ab,kw OR (analges*):ti,ab,kw AND (antimicrobial):ti,ab,kw OR (antibiotic):ti,ab,kw

Process of study selection and eligibility criteria

A reference management software, Covidence will be utilized to systematically organize all retrieved studies and eliminate duplicates.29 All search results were imported into Covidence to facilitate organization, deduplication, and efficient tracking of individual studies. In first stage (Title/Abstract Screening), a team of investigators will independently screen the titles and abstracts of retrieved citations to assess their likelihood of inclusion. In second stage (Full text screening) potentially eligible articles will undergo a duplicate independent review by the investigators, who will assess them against the predefined inclusion and exclusion criteria. Any disagreements among reviewers will be clarified through group discussions to achieve a mutual agreement. The total number of identified studies will be documented in the PRISMA flow diagram.

Process of data collection and elements

A pre-established data extraction form will be utilized by two independent reviewers to extract data from the eligible studies. The extracted data will include the author’s first name, date of publication, design of study, country of data collection, sample size, participant age range and mean, indication for antibiotic prescription, antibiotic name, route of administration, duration of use, use of additional analgesics, type of randomized controlled trial, and other key outcome measures. Any disagreements through the data collection process will be resolved through discussion between the independent reviewers. The corresponding authors will be contacted for missing or unclear data. If no response is received after two attempts, the article will be classified as having insufficient data and excluded.

Assessment of quality of studies and certainty of evidence

The Cochrane Collaboration Risk of Bias 2 (RoB 2) tool will be used to assess the methodological quality of the included randomized controlled trials.30 This tool assesses five key domains which include randomization process, deviations from intended interventions, missing outcome data, outcome measurement, and selective reporting. Study will be classified as low risk, some concerns, or high risk of bias. The results will be visually represented using a traffic light plot and a summary table to illustrate the risk of bias across studies.

The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) Framework31 will be applied to determine the overall certainty of evidence. This assessment will consider risk of bias (derived from RoB 2), inconsistency (variation in results), indirectness (applicability of evidence to the research question), imprecision (confidence in effect estimates), and publication bias. Based on these factors, the evidence generated will be categorized into high, moderate, low or very low, ensuring a structured and transparent evaluation of study reliability. Any differences in data extraction will be resolved by mutual discussions. The publication bias will be assessed through funnel plots and Begg’s test if atleast 10 studies are available for meta- analysis.

Data analysis and evidence synthesis

Strategy for data synthesis

Review Manager (RevMan) Version 5.4, The Cochrane Collaboration, 2020 will be used for the meta-analysis using odds ratio and mean difference with 95% confidence interval rates.32 Heterogeneity will be quantified using I2 statistic test. The fixed effects model will be preferred but wherever the value of I2 is more than 50% and/or clinical heterogeneity is high, the random effects model will be employed.

Analysis of subgroups or subsets

Subgroup analysis will be employed based on age groups (Children less than 18 yrs, Adults more than equal to 18 to 60 years, geriatric more than 60 years), disadvantaged groups (Pregnant women, lactating mothers; Patients with associated co-morbidities such as immunocompromised patients, cancer patients, diabetics, patients with liver and kidney dysfunctions etc.), severity of pain (Mild/moderate/severe), origin of pain (Endodontic origin/periodontal origin/soft tissue/glandular/bony/others) and route of administration (Oral, parenteral).

Ethics and dissemination

Since no original data will be collected, ethical approval is not necessary. The review's findings will be shared through publications, conference presentations, seminars, social media, and press release.

Results

The database search is set to start in February 2025, with data extraction from individual studies scheduled for completion by March 2025. The processes of evaluating, organizing, summarizing, and analyzing the data are expected to be concluded by April 2025, while the meta-analysis and certainty of evidence assessment is projected to be finalized by May 2025.

Discussion

Several systematic reviews and clinical guidelines emphasize antibiotic stewardship strategies aimed at minimizing unnecessary antibiotic use.16–20 This systematic review will comprehensively assess the existing evidence on antibiotic use in the management of oro-facial pain, focusing on key outcomes such as pain relief, quality of life, adverse events, AMR, clinical resolution of signs and symptoms and cost considerations. The findings of this review will provide dental practitioners and healthcare providers with an evidence-based decision-support system regarding the appropriate indications for antibiotic use, the optimal duration of therapy, and the selection of specific antibiotics for oral disease management. Additionally, the review will generate critical evidence to inform policymakers and national and international dental organizations in the development of clinical practice guidelines for antibiotic prescription and in reinforcing antimicrobial stewardship strategies within dental settings. Given the global concern surrounding antibiotic misuse, the findings of this review will also serve as a foundation for designing educational interventions aimed at promoting rational antibiotic-prescribing behaviours among dental professionals.

We anticipate potential heterogeneity among the included studies due to variations in antibiotic types, duration of use, disease conditions, and reported outcomes. To address heterogeneity, we will employ a rigorous methodological approach, including well-defined inclusion and exclusion criteria, a standardized data extraction process, and quality assessment using the Cochrane RoB 2 tool. Furthermore, subgroup analyses will be conducted based on age, disease condition, duration of antibiotic use, route of administration, and other relevant factors as needed. We expect this systematic review shall provide fresh perspectives to this field of antibiotic research in dentistry, inspiring further investigations and guiding future studies.

Ethics and consent

Ethical approval and consent were not required.

Data availability

No data associated with this article.

Reporting guidelines

Figshare: PRISMA-P checklist for ‘[Systematic review protocol on antibiotic use for orofacial pain: Policy and practice implications]’. https://doi.org/10.6084/m9.figshare.28682657.33

Data are available under the terms of the Creative Commons Zero “No rights reserved” data waiver (CC0 1.0 Public domain dedication).

Acknowledgements

Nil

References

  • 1.  Delgado-Pérez VJ, Patiño-Marín N, Rueda-Ibarra V, et al.: Epidemiological and Oral Public Health Aspects of Dental Pain: A Narrative Review. Cureus. 2024; 16(12): e74908. PubMed Abstract | Publisher Full Text
  • 2.  Buonavoglia A, Leone P, Solimando AG, et al.: Antibiotics or no antibiotics, that is the question: An update on efficient and effective use of antibiotics in dental practice. Antibiotics. 2021; 10(5): 1–20. Publisher Full Text
  • 3.  Soleymani F, Pérez-Albacete Martínez C, Makiabadi M, et al.: Mapping Worldwide Antibiotic Use in Dental Practices: A Scoping Review. Antibiotics. 2024; 13(9): 859. PubMed Abstract | Publisher Full Text | Free Full Text
  • 4.  Tousi F, Al Haroni M, Lie SA, et al.: Antibiotic prescriptions among dentists across Norway and the impact of COVID-19 pandemic. BMC Oral Health. 2023; 23(1): 1–10. Publisher Full Text
  • 5.  WHO: World Health Organization. Promoting rational use of medicines: core components. WHO Policy Perspectives on Medicines. 2002; pp. 1–6. [Accessed on 2025-3-10]. Reference Source
  • 6.  Subhashinee Dhanasekaran A, Muthalagappan PL, Prasanth S, et al.: A Systematic Review on the Role of Antibiotics and Analgesics in Systemically Ill Patients Undergoing Tooth Extraction. Cureus. 2024; 16(5): e59711. PubMed Abstract | Publisher Full Text | Free Full Text
  • 7.  Lockhart PB, Tampi MP, Abt E, et al.: Evidence-based clinical practice guideline on antibiotic use for the urgent management of pulpal- and periapical-related dental pain and intraoral swelling: A report from the American Dental Association. J. Am. Dent. Assoc. 2019; 150(11): 906–921.e12. PubMed Abstract | Publisher Full Text
  • 8.  Maslamani M, Sedeqi F: Antibiotic and Analgesic Prescription Patterns among Dentists or Management of Dental Pain and Infection during Endodontic Treatment.2018; 27(1): 66–72.
  • 9.  Salako NO, Rotimi VO, Adib SM, et al.: Pattern of antibiotic prescription in the management of oral diseases among dentists in Kuwait.2004; pp. 503–509.
  • 10.  Bdsc LT, Thompson W, Pharmd KS: Antimicrobial stewardship in dental practice. J. Am. Dent. Assoc. 2020; 151(8): 589–595.
  • 11.  Tufa TB, Regassa F, Amenu K, et al.: Livestock producers’ knowledge, attitude, and behavior (KAB) regarding antimicrobial use in Ethiopia. Front. Vet. Sci. 2023; 10: 1–20.
  • 12.  Gross AE, Hanna D, Rowan SA, et al.: Successful implementation of an antibiotic stewardship program in an academic dental practice. Open Forum Infect. Dis. 2019; 6(3): 1–6.
  • 13.  Suda KJ, Henschel H, Patel U, et al.: Use of antibiotic prophylaxis for tooth extractions, dental implants, and periodontal surgical procedures. Open Forum Infect. Dis. 2018; 5(1): 13–16.
  • 14.  Löffler C, Böhmer F: The effect of interventions aiming to optimise the prescription of antibiotics in dental care — A systematic review. PLoS One. 2017; 12(11): 1–23. Publisher Full Text
  • 15.  World Health Organization: Antimicrobial resistance. Geneva: WHO; 2023. [Accessed on 2025-3-11]. Reference Source
  • 16.  Dar-odeh N, Fadel HT: Antibiotic Prescribing for Oro-Facial Infections in the Paediatric Outpatient: A Review.2018; pp. 1–17.
  • 17.  Contaldo M, D'Ambrosio F, Ferraro GA, et al.: Antibiotics in dentistry: a narrative review of the evidence beyond the myth. Int. J. Environ. Res. Public Health. 2023; 20(11): 6025. PubMed Abstract | Publisher Full Text | Free Full Text
  • 18.  Abdullah FM, Hatim QY, Oraibi AI, et al.: Antimicrobial management of dental infections: updated review. Medicine (Baltimore). 2024; 103(27): e38630. PubMed Abstract | Publisher Full Text | Free Full Text
  • 19.  Oberoi SS, Dhingra C, Sharma G, et al.: Antibiotics in dental practice: how justified are we? Int. Dent. J. 2015; 65(1): 4–10. PubMed Abstract | Publisher Full Text
  • 20.  Guerrini L, Monaco A, Pietropaoli D, et al.: Antibiotics in dentistry: a narrative review of literature and guidelines considering antibiotic resistance. Open Dent. J. 2019; 13: 383–398. Publisher Full Text
  • 21.  Palin V, Welfare W, Ashcroft DM, et al.: Shorter and longer courses of antibiotics for common infections and the association with reductions of infection-related complications including hospital admissions. Clin. Infect. Dis. 2021; 73(10): 1805–1812. PubMed Abstract | Publisher Full Text
  • 22.  Mathur MR, Nagrath D, Mishra VK, et al.: Antibiotic prescriptions for oral diseases in India: evidence from national prescription data. BMC Oral Health. 2023; 23(1): 1–8. Publisher Full Text
  • 23.  Garg AK, Agrawal N, Tewari RK, et al.: Antibiotic prescription pattern among Indian oral healthcare providers: a cross-sectional survey. J. Antimicrob. Chemother. 2014; 69(2): 526–528. PubMed Abstract | Publisher Full Text
  • 24.  Thoudam BD, Santosh HN, Bose A, et al.: Antibiotic prescription pattern among dentists in Imphal city of North East India. Int. J. Oral Health Sci. 2021; 11(2): 109–113.
  • 25.  Goyal R, Krishna S, Gupta Y: Survey on the antibiotic prescription pattern: a questionnaire based on North Indian population. Acta Sci. Dent. Sci. 2024; 8(2): 55–61.
  • 26.  Kar SS, Pradhan HS, Mohanta GP: Concept of essential medicines and rational use in public health. Indian J. Community Med. 2010; 35(1): 10–13. PubMed Abstract | Publisher Full Text | Free Full Text
  • 27.  Moher D, Shamseer L, Clarke M, et al.: Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst. Rev. 2015; 4(1): 1. PubMed Abstract | Publisher Full Text
  • 28.  Gupta A, Mehta N, Shrivastava R, et al.: Antibiotic use for the management of oro-dental pain: a systematic review. PROSPERO. 2025; CRD420250610118. Accessed March 10, 2025. Reference Source
  • 29.   Covidence systematic review software. Melbourne, Australia: Veritas Health Innovation; 2025. Accessed March 10, 2025. Reference Source
  • 30.  Sterne JA, Savović J, Page MJ, et al.: RoB 2: a revised tool for assessing risk of bias in randomized trials. BMJ. 2019; 366: l4898. Publisher Full Text
  • 31.  Shao SC, Kuo LT, Huang YT, et al.: Using grading of recommendations assessment, development, and evaluation (GRADE) to rate the certainty of evidence of study outcomes from systematic reviews: a quick tutorial. Dermatol. Sin. 2023; 41(1): 3–7.
  • 32.   Review Manager (RevMan) [Computer program]. Version 5.4. Copenhagen: The Cochrane Collaboration; 2020. Accessed March 11, 2025. Reference Source
  • 33.  Mehta N, Shrivastava R, Patyal N, et al.: Systematic review protocol on antibiotic use for orofacial pain: Policy and practice implications.2025. Extended data. Publisher Full Text

Comments on this article Comments (0)

Version 2
VERSION 2 PUBLISHED 08 Apr 2025
Comment
Author details Author details
Competing interests
Grant information
Article Versions (2)
Copyright
Download
 
Export To
metrics
Views Downloads
F1000Research - -
PubMed Central
Data from PMC are received and updated monthly.
 - -
Citations
SEE MORE DETAILS
CITE
how to cite this article
Mehta N, Shrivastava R, Patyal N and Gupta A. Systematic review protocol on antibiotic use for orofacial pain: Policy and practice implications [version 1; peer review: 1 approved, 1 approved with reservations]. F1000Research 2025, 14:415 (https://doi.org/10.12688/f1000research.163353.1)
NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article.
track
receive updates on this article
Track an article to receive email alerts on any updates to this article.

Open Peer Review

Current Reviewer Status: ?
Key to Reviewer Statuses VIEW
ApprovedThe paper is scientifically sound in its current form and only minor, if any, improvements are suggested
Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit.
Not approvedFundamental flaws in the paper seriously undermine the findings and conclusions
Version 1
VERSION 1
PUBLISHED 08 Apr 2025
Views
5
Cite
Reviewer Report 27 May 2025
Sanjana Santhosh Kumar, University of Rochester, Rochester, New York, USA 
Approved with Reservations
VIEWS 5
https://doi.org/10.5256/f1000research.179686.r384236
The topic is very relevant and important to acknowledge. The introduction is well written. The methods section is comprehensive; however, the rationale for including only randomized controlled trials (RCTs) warrants further justification, especially considering the potential scarcity of such ... Continue reading
CITE
CITE
HOW TO CITE THIS REPORT
Kumar SS. Reviewer Report For: Systematic review protocol on antibiotic use for orofacial pain: Policy and practice implications [version 1; peer review: 1 approved, 1 approved with reservations]. F1000Research 2025, 14:415 (https://doi.org/10.5256/f1000research.179686.r384236)
The direct URL for this report is:
https://f1000research.com/articles/14-415/v1#referee-response-384236
NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article.
Report a concern
  • Author Response 09 Aug 2025
    Arpit Gupta, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
    09 Aug 2025
    Author Response
    We acknowledge concerns regarding the potential scarcity of RCTs in dental antibiotic research. However, we chose to include only RCTs to synthesize the highest level of evidence, reduce bias, and ... Continue reading
    Report a concern
  • Respond or Comment
COMMENTS ON THIS REPORT
  • Author Response 09 Aug 2025
    Arpit Gupta, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
    09 Aug 2025
    Author Response
    We acknowledge concerns regarding the potential scarcity of RCTs in dental antibiotic research. However, we chose to include only RCTs to synthesize the highest level of evidence, reduce bias, and ... Continue reading
    Report a concern
Views
5
Cite
Reviewer Report 26 May 2025
Lydia N. Melek, Alexandria University, Alexandria, Egypt 
Approved
VIEWS 5
https://doi.org/10.5256/f1000research.179686.r384234
The protocol is accurately designed and written following the guidelines of systematic reviews. The topic is interesting and useful for practitioners. However, I prefer adding the word "resulting from infection" to "orofacial pain" in the title. The word orofacial pain ... Continue reading
CITE
CITE
HOW TO CITE THIS REPORT
Melek LN. Reviewer Report For: Systematic review protocol on antibiotic use for orofacial pain: Policy and practice implications [version 1; peer review: 1 approved, 1 approved with reservations]. F1000Research 2025, 14:415 (https://doi.org/10.5256/f1000research.179686.r384234)
The direct URL for this report is:
https://f1000research.com/articles/14-415/v1#referee-response-384234
NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article.
Report a concern
  • Author Response 09 Aug 2025
    Arpit Gupta, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
    09 Aug 2025
    Author Response
    We have revised the title as suggested to clarify the scope of the review. The new title is: “Systematic Review Protocol on Antibiotic Use for Infection-Related Orofacial Pain: Policy and ... Continue reading
    Report a concern
  • Respond or Comment
COMMENTS ON THIS REPORT
  • Author Response 09 Aug 2025
    Arpit Gupta, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
    09 Aug 2025
    Author Response
    We have revised the title as suggested to clarify the scope of the review. The new title is: “Systematic Review Protocol on Antibiotic Use for Infection-Related Orofacial Pain: Policy and ... Continue reading
    Report a concern

Comments on this article Comments (0)

Version 2
VERSION 2 PUBLISHED 08 Apr 2025
Comment

Open Peer Review

Reviewer Status

Alongside their report, reviewers assign a status to the article:

Approved
The paper is scientifically sound in its current form and only minor, if any, improvements are suggested
Approved with reservations
A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit.
Not approved
Fundamental flaws in the paper seriously undermine the findings and conclusions

Reviewer Reports

Invited Reviewers
1 2
Version 2
(revision)
 22 Jul 25 		read
Version 1
08 Apr 25 		read read
  1. Lydia N. Melek, Alexandria University, Alexandria, Egypt
  2. Sanjana Santhosh Kumar, University of Rochester, Rochester, USA

Comments on this article

All Comments(0)

Add a comment
Sign up for content alerts

Browse by related subjects

    keyboard_arrow_left Back to all reports
    keyboard_arrow_left Back to all reports
    keyboard_arrow_left Back to all reports
    Alongside their report, reviewers assign a status to the article:
    Approved - the paper is scientifically sound in its current form and only minor, if any, improvements are suggested
    Approved with reservations - A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit.
    Not approved - fundamental flaws in the paper seriously undermine the findings and conclusions
    Sign In
    If you've forgotten your password, please enter your email address below and we'll send you instructions on how to reset your password.

    The email address should be the one you originally registered with F1000.
    Email address not valid, please try again

    You registered with F1000 via Google, so we cannot reset your password.

    To sign in, please click here.

    If you still need help with your Google account password, please click here.

    You registered with F1000 via Facebook, so we cannot reset your password.

    To sign in, please click here.

    If you still need help with your Facebook account password, please click here.

    Code not correct, please try again
    Email us for further assistance.
    Server error, please try again.