Dental antibiotics

For acute dental and gum infections, examples of suitable antibiotics include (adult doses) for 5 days:

- amoxicillin 500mg 8-hourly orally, or,

- metronidazole 400mg 8-hourly orally, or,

- if penicillin allergic: clarithromycin 500mg 12-hourly orally

• clindamycin is an alternative for severe infection but there is concomitant risk of developing Clostridium difficile associated diarrhoea

For cellulitis/severe infection (if spreading infection (lymph node involvement, or systemic signs i.e. fever or malaise), use amoxicillin plus metronidazole (or clarithromycin plus metronidazole if penicillin allergic)

Rinsing with Chlorhexidine mouthwash 10ml twice daily can be used for chronic gingivitis.

All patients should be advised they must seek a dentist's advice as these are only emergency measures.

Check with local prescribing guidelines for the treatment of dental infections before prescribing medication.

Reference

1. Bratton TA et al. Management of complex multi-space odontogenic infections. J Tenn Dent Assoc. 2002 Fall;82(3):39-47.