Sir, I read with interest the letter by Pankhurst et al. (BDJ 2016; 220: 2–3) advocating the creation of more consultant oral microbiologists to 'provide a high calibre skills base...[to] modernise the surveillance of [antibiotic] drug resistance' as highlighted by the O'Neill report. This expanded group would mainly continue to 'oversee instrument decontamination and antibiotic stewardship' (presumably by educating and re-educating medical and dental professionals). On page 5 of the same issue in the BDJ in the 'News' section we learn that 'The rise of resistance to antibiotics is largely a consequence of human action and is as much a societal problem as a technological one' and the Economic and Social Research Council have recently been funded to look at this from the social science angle and raise awareness in that field.

This sounds a bit like climate change to me. We can all 'see' the problem, but vested interests, money and various other territorial and political standpoints will increase the numbers of related conferences and discussions exponentially but antibiotic resistance and over-prescribing will remain a very big nut to crack. I also read the other day that medical GPs' remuneration is partly based on 'patient satisfaction' – which could further muddy the water in the UK in respect of antibiotic prescribing.

Where does that leave us as humble UK dentists? So long as we continue to see patients who have been prescribed a course of antibiotics for a draining endodontic sinus then we must be prepared to admit that we have a problem. And that could be addressed by bypassing most of the above.

1. Newbury, Berkshire