Dental & oral

• Antibiotics are only required if:
  • immediate drainage is not achieved OR
  • in cases of spreading infection (significant extra-oral swelling, cellulitis) OR
  • systemic involvement (e.g. fever, sepsis).
• Where possible all dental prescribing should be by a dentist except where this would cause unacceptable delay in treatment.

Consider HIV test if severe/extensive/recurrent 

Adults >16 (non-immunocompromised):

Nystatin dose OR Miconazole oromucosal gel dose

If severe/extensive: oral Fluconazole dose, consider extending to 14 days

Duration: 7 days

Children <16, immunocompromised, or HIV positive:

Refer to: NICE/CKS Candida (oral) guidance

Refer to dental practitioner for suspected dental abscess.

Phenoxymethylpenicillin dose

Penicillin Allergy: Metronidazole dose

Duration: 5 days

Further information:

• SDCEP guidance
• SAPG Statement: Phenoxymethylpenicillin recommended first line when antibiotics are required for acute dento-alveolar infections

Clotrimazole creamdose

If significant inflammation: Clotrimazole/Hydrocortisone 1% cream (BD)

If no response and/or swabs grow Staphylococcus aureus/lugdenensis: Fusidic acid (+/- Hydrocortisone 1%) cream (BD)

Duration: 7 - 14 days

Refer to: NICE/CKS Herpes Simplex (oral) guidance