Background <p>In 2016, dentists accounted for 5.8% of all outpatient antibiotic prescriptions in Belgium. This study evaluated antibiotic prescribing trends in dental practice from 2014 to 2023 in Belgium and explored the influence of prescriber demographics (age, sex and specialty), and of the COVID-19 pandemic on prescribing behaviour.</p> Methods <p>Data on reimbursed systemic antibiotics (ATC J01) prescribed by dentists and dispensed by Belgian community pharmacies from 2014 to 2023 were quantified in Defined Daily Doses (DDDs) and expressed as DDD per 1000 insured beneficiaries per day (DBD). This was combined with data on dentist demographics (age, sex, specialty) and professional activity (annual number of consultations for 2018–2022) to assess prescribing behaviour.</p> Results <p>Total antibiotic prescriptions by Belgian dentists (measured in DDD) increased by 13.5% from 2014 to 2023. Despite a 3.1% reduction in DDD in 2020, the volume of J01 antibiotics prescribed per consultation increased during that year. The proportion of total outpatient J01 antibiotic deliveries prescribed by dentists increased from 4.9% in 2014 to 6.4% in 2023, with a peak of 7.3% in 2021. Male and older dentists consistently prescribed more antibiotics than their younger and female counterparts. Following the introduction of national antibiotic guidelines for dentistry in 2020 we observed limited change in the proportion of recommended antibiotics prescribed.</p> Conclusion <p>Antibiotic prescribing among Belgian dentists is influenced by various factors, including prescriber characteristics and external disruptions such as the COVID-19 pandemic. Opportunities remain to optimize prescribing practices, and efforts should focus on encouraging guideline-based antibiotic use only when necessary.</p>