interactions will become an even greater concern in dental practice (Moore 1999). This study showed that the investigated sample of dentists had a tendency towards neglecting documentation of essential clinical data, in spite of the fact that they knew in advance about the nature of the study. The full elements of a prescription include generic name of the drug, its form, dose, frequency, and quantity. These elements were absent. Instead, information recorded was the category of the drug. Ie, either antibiotic, analgesic, mouthwash, etc. This is not sufﬁcient to prevent certain issues that might complicate the treatment plan and proceed to unfavorable consequences. A comprehensive treatment plan should be documented for future reference of the treating doctor and other members of the health care team. Since it is not known whether a certain patient obtained a prescription from a dentist, that this patient might try to get the same prescription from other dentists. When prescriptions issued during the period of study were analyzed, there was a case of a patient who has been seen by three different specialists, and each prescribed a different analgesic. The only satisfactory way to obtain detailed prescriptions issued by the dental department was through the computer database of the pharmaceutical department. However, this is not adequate, since the clinical indications for such pre- scriptions were not documented. There was no indication in any record for patients to whom antibiotics were prescribed as to whether the prescribed antibiotics was prophylactic or therapeutic. It was not the aim of this study to analyze the prescriptions or the local anesthetic injections given by the study sample of dental practitioners. However, analysis of the prescrip- tions was essential to obtain enough data about the pattern of record keeping in the department. It was noted that the pattern of antibiotic prescription was similar to what was observed in a previous study on the same sample of dental practitioners (Dar-Odeh et al 2008). Antibiotic prescrip- tion by dentists has been given great attention worldwide (Epstein et al 2000; Al-Mubarak et al 2004; Salako et al 2004; Demirbas et al 2006; Chate et al 2006; Murti and Morse 2007). Contributing to the very high dentist-based prescriptions of certain antimicrobials (Al-Haroni 2008), broad-spectrum antibiotics (amoxicillin-clavulinic acid and cephalosporins) were mainly prescribed in this study. Amoxicillin may encourage emergence of resistant organ- isms (Dental Practitioner’s Formulary 2006). The number of prescriptions was limited (about 2 prescriptions per day). A recent study estimated that a dental practitioner could be Therapeutics and Clinical Risk Management 2008:4(5) Documentation of drug prescriptions and local anesthetic injections prescribing on average 3 prescriptions a week (Sweeney et al 2004). Dentists tended to issue long prescriptions. It is advised that short prescriptions replace long ones for justiﬁ- able reasons. Patients usually conform to short rather than long prescriptions. Short-course oral therapy for the dental abscess according to Dental Practitioner’s Formulary (2006), is 3 gram amoxicillin, repeated after 8 hours. In third world countries antibiotic resistance represents a major health problem, and there are still many countries where antibiotics are available over the counter (Handal and Olsen 2000). In Europe, antimicrobial resistance appears to be increasing (Goossens 2005). Reduction in antibiotic resistance can only occur following a signiﬁcant reduction in antibiotic use (Sweeney et al 2004). Single or combined drug therapies have become more important in dental practice, but whenever possible, single drug therapies should be prescribed to reduce the incidence of side effects, emergence of resistant bacteria, and cost of therapy (Al-Haroni 2008). The Medication Appropriateness Index depends on 10 important questions (Hanlon et al 1992; Samsa et al 1994) among which are: is there an indication for the drug? And is there unnecessary duplication with other drugs? These requirements can simply be fulﬁlled by documenting the patient’s clinical condition and the prescribed medications in the patient’s record. Most analgesics prescribed were NSAIDs. Paracetamol was prescribed to a lower degree and opioid analgesics were the least prescribed. Most dental pain is relieved effectively by NSAIDs (Dental Practioner’s Formulary 2006). However, paracetamol is the preferred analgesic for children, elderly patients, patients with bleeding tendency and patients with peptic ulcer. It is a safe drug when taken in recommended dosages for a short duration, consistent with the management of acute pain in dentistry (Haas 1999). Based on data collected by this study, it seems that non- clinical rather than clinical reasons still affect prescribing. Inappropriate reasons for prescribing include uncertainty of diagnosis, pressure of time, patient expectation, pain, and localized swelling (Palmer et al 2001). Although a number of dental practitioners documented the use of local anesthesia, the full elements of a local anesthetic injection were not documented except in a very limited number of records. Describing the local anesthetic procedure includes the type and concentration of local anesthetic agent, the type and concentration of the vasoconstrictor if used, the anesthetic procedure and the quantity of the local anesthetic solution given to the patient. Any resulting local or systemic complication should also be documented. An unusual or 1115