Anxiety
Drug prescribed
Diazepam 5mg, 1 tablet. Take 1 tablet 2 hours before procedure
Advised the patient they will require a responsible, adult escort for their appointment and they should not drive for at least 24 hours.
Diazepam 10mg, 1 tablet. Take 1 tablet 2 hours before procedure
Advised the patient they will require a responsible, adult escort for their appointment and they should not drive for at least 24 hours.
Sinusitis
Adults (18 and over)
Drug prescribed
Ephedrine nasal drops 0.5% 10ml, 1 drop into each nostril up to three times daily when required
Amoxicillin 500mg, 21 capsules, 1 capsule three times daily
Doxycycline 100mg, 8 capsules, take 2 capsules on the first day followed by 1 capsule daily
12–17 years
Drug prescribed
Ephedrine nasal drops 0.5% 10ml, 1 drop into each nostril up to three times daily when required
Amoxicillin 500mg, 21 capsules, 1 capsule three times daily
Doxycycline 100mg, 8 capsules, take 2 capsules on the first day followed by 1 capsule daily
5-11
Drug prescribed
Amoxicillin 250mg/5ml SF oral suspension, 10ml three times daily
1-4
Drug prescribed
Amoxicillin 250mg/5ml SF oral suspension, 5ml three times daily
6-11 months
Drug prescribed
Amoxicillin 125mg/5ml SF oral suspension, 5ml three times daily
Dental abscess
Adults (18 and over)
1st line drug prescribed
Amoxicillin 500mg, 15 capsules, 1 capsule three times daily
Metronidazole 400mg, 15 tablets, 1 tablet three times daily
Phenoxymethylpenicillin 250mg, 40 tablets, 2 tablets four times daily
2nd line drug prescribed
Clindamycin 150mg, 20 capsules, 1 capsule four times daily swallowed with water
Advised patient to discontinue use immediately if diarrhoea or colitis develops
Co-amoxiclav 250/125, 15 tablets, 1 tablet three times daily
Clarithromycin 250mg, 14 tablets, 1 tablet two times daily
12–17 years
1st line drug prescribed
Amoxicillin 500mg, 15 tablets, 1 tablet three times daily
Metronidazole 200mg, 15 tablets, 1 tablet three times daily
Phenoxymethylpenicillin 250mg/5ml SF oral suspension, 10ml four times daily
2nd line drug prescribed
Clindamycin 150mg, 20 capsules, 1 capsule four times daily swallowed with water
Advised patient to discontinue use immediately if diarrhoea or colitis develops
Co-amoxiclav 250/125mg, 15 tablets, 1 tablet three times daily
Clarithromycin 250mg, 14 tablets, 1 tablet two times daily
10-11 years
1st line drug prescribed
Amoxicillin 250mg/5ml SF oral suspension, 10ml three times daily
Metronidazole 200mg, 15 tablets, 1 tablet three times daily
Phenoxymethylpenicillin 250mg/5ml SF oral suspension, 5ml four times daily
2nd line drug prescribed
Clarithromycin 125-250mg (depending on weight), 14 tablets, 1 tablet two times daily
1-9 years
1st line drug prescribed
Amoxicillin 250mg/5ml SF oral suspension, 5ml three times daily
Metronidazole 200mg/5ml SF oral suspension, 1.25ml three times daily
Phenoxymethylpenicillin 125mg/5ml SF oral suspension, 5ml four times daily
2nd line drug prescribed
Clarithromycin 125-250mg (depending on weight), 14 tablets, 1 tablet two times daily
6-11 months
Drug prescribed
Amoxicillin 125mg/5ml SF oral suspension, 5ml three times daily
Phenoxymethylpenicillin 125mg/5ml, 2.5ml four times daily
NUG & pericoronitis
18+ yrs
Drug prescribed
Metronidazole 400mg, 9 tablets, 1 tablet three times daily
Amoxicillin 500mg, 9 tablets, 1 tablet three times daily
12-17 yrs
Drug prescribed
Metronidazole 200mg, 9 tablets, 1 tablet three times daily
Amoxicillin 500mg, 9 tablets, 1 tablet three times daily
10-11 yrs
Drug prescribed
Metronidazole 200mg, 9 tablets, 1 tablet three times daily
Amoxicillin 250mg/5ml SF oral suspension, 10ml three times daily
7-9 yrs
Drug prescribed
Metronidazole 200mg/5ml SF oral suspension, 2.5ml three times daily
Amoxicillin 250mg/5ml SF oral suspension, 10ml three times daily
5-6
Drug prescribed
Metronidazole 200mg/5ml SF oral suspension, 2.5ml twice daily
Amoxicillin 250mg/5ml SF oral suspension, 10ml three times daily
3-4
Drug prescribed
Metronidazole 200mg/5ml SF oral suspension, 2.5ml two times daily
Amoxicillin 250mg/5ml SF oral suspension, 5ml three times daily
1-2
Drug prescribed
Metronidazole 200mg/5ml SF oral suspension, 1.25ml three times daily
Amoxicillin 250mg/5ml SF oral suspension, 5ml three times daily
6-11 months
Drug prescribed
Amoxicillin 125mg/5ml SF oral suspension, 5ml three times daily
Fungal infection
Candidosis
Adults (18 and over)
Drug prescribed
Fluconazole 50mg, 7 capsules, 1 capsule daily
Miconazole oromucosal gel SF 20mg/g, 80g tube, apply a pea sized amount after food four times daily. Continue to use 7 days after lesions have healed.
Nystatin oral suspension 100,000 units/ml, 30ml bottle, 1ml after food four times daily for 7 days, remove dentures before using, rinse around mouth then retain suspension near lesion for 5 minutes before swallowing. Continue to use 48 hours after lesions have healed.
12–17 years
Drug prescribed
Fluconazole 50mg, 7 capsules, 1 capsule daily
Miconazole oromucosal gel SF 20mg/g, 80g tube, Apply a pea-sized amount after food four times daily. Continue to use 7 days after lesions have healed
Nystatin oral suspension 100,000 units/ml, 30ml, 1ml after food four times daily for 7 days. Remove dentures before using drug, rinse suspension around mouth and then retain suspension near lesion for 5 minutes before swallowing. Continue to use for 48 hours after lesions have healed.
2-11
Drug prescribed
Fluconazole 50mg/5ml oral suspension, 3-6mg/kg on first day then 3mg/kg (max 50mg) daily for 7 days
Miconazole oromucosal gel SF 20mg/g, 80g tube, Apply a pea-sized amount after food four times daily. Continue to use 7 days after lesions have healed
Nystatin oral suspension 100,000 units/ml, 30ml, 1ml after food four times daily for 7 days. Rinse suspension around mouth and then retain suspension near lesion for 5 minutes before swallowing. Continue to use for 48 hours after lesions have healed.
6-11 months
Drug prescribed
Nystatin oral suspension 100,000 units/ml, 30ml, 1ml after food four times daily for 7 days. Rinse suspension around mouth and then retain suspension near lesion for 5 minutes before swallowing. Continue to use for 48 hours after lesions have healed.
Denture stomatitis
Adults (18 and over)
Drug prescribed
Fluconazole 50mg, 7 capsules, 1 capsule daily
Miconazole oromucosal gel SF 20mg/g, 80g tube, apply a pea sized amount after food four times daily. Continue to use 7 days after lesions have healed.
Nystatin oral suspension 100,000 units/ml, 30ml bottle, 1ml after food four times daily for 7 days, remove dentures before using, rinse around mouth then retain suspension near lesion for 5 minutes before swallowing. Continue to use 48 hours after lesions have healed.
12–17 years
Drug prescribed
Fluconazole 50mg, 7 capsules, 1 capsule daily
Miconazole oromucosal gel SF 20mg/g, 80g tube, Apply a pea-sized amount after food four times daily. Continue to use 7 days after lesions have healed
Nystatin oral suspension 100,000 units/ml, 30ml, 1ml after food four times daily for 7 days. Remove dentures before using drug, rinse suspension around mouth and then retain suspension near lesion for 5 minutes before swallowing. Continue to use for 48 hours after lesions have healed.
2-11
Drug prescribed
Fluconazole 50mg/5ml oral suspension, 3-6mg/kg on first day then 3mg/kg (max 50mg) daily for 7 days
Miconazole oromucosal gel SF 20mg/g, 80g tube, Apply a pea-sized amount after food four times daily. Continue to use 7 days after lesions have healed
Nystatin oral suspension 100,000 units/ml, 30ml, 1ml after food four times daily for 7 days. Rinse suspension around mouth and then retain suspension near lesion for 5 minutes before swallowing. Continue to use for 48 hours after lesions have healed.
6-11 months
Drug prescribed
Nystatin oral suspension 100,000 units/ml, 30ml, 1ml after food four times daily for 7 days. Rinse suspension around mouth and then retain suspension near lesion for 5 minutes before swallowing. Continue to use for 48 hours after lesions have healed.
Angular cheilitis
Drug prescribed
Miconazole cream 2%, 20g tube, Apply to angles of mouth twice daily. Continue to use for 10 days after lesions have healed.
Sodium fusidate ointment 2%, 15g tube, apply to angles of mouth twice daily
Miconazole (2%) and Hydrocortisone (1%) cream, 30g tube, Apply to angles of mouth twice daily
Miconazole (2%) and Hydrocortisone (1%) ointment, 30g tube, Apply to angles of mouth twice daily
Odontogenic pain
Drug prescribed
Diclofenac sodium 50mg, 15 tablets, 1 tablet three times daily
Facial pain
Drug prescribed
Carbamazepine 100mg, 20 tablets, 1 tablet twice daily. Space out doses as much as possible throughout day.
Ulceration and inflammation
Antimicrobial mouthwashes
>12 years
Drug prescribed
Chlorhexidine mouthwash 0.2%, 300ml, rinse mouth for 1 minute with 10ml twice daily. Spit out mouthwash after rinsing and continue to use until lesions have resolved
Hydrogen peroxide mouthwash 6%, 300ml, rinse mouth for 2 minutes with 15ml diluted in half a glass of warm water three times daily. Spit out mouthwash after rinsing and continue to use until lesions have resolved
Doxycycline dispersible tablets 100mg, 48 tablets, 1 tablet to be dissolved in water and rinsed around the mouth for 2 minutes four times daily for three days at the onset of ulceration. Spit out mouthwash after rinsing
<12 years
Drug prescribed
Chlorhexidine mouthwash 0.2%, 300ml, rinse mouth for 1 minute with 10ml twice daily. Spit out mouthwash after rinsing and continue to use until lesions have resolved
Hydrogen peroxide mouthwash 6%, 300ml, rinse mouth for 2 minutes with 15ml diluted in half a glass of warm water three times daily. Spit out mouthwash after rinsing and continue to use until lesions have resolved
Local analgesics
6 years +
Drug prescribed
Benzydamine mouthwash 0.15%, 300ml, rinse or gargle using 15ml every 1.5 hours as required.
Benzydamine oromucosal spray 0.15%, 30ml, 4 sprays onto affected area every 1.5 hours as required.
Lidocaine ointment 5%, 15g tube, rub sparingly and gently onto dried affected area
Lidocaine spray 10%, 50ml, apply as necessary with a cotton bud
under 6 years
Drug prescribed
Benzydamine oromucosal spray 0.15%, 30ml, 1 spray per 4kg bodyweight up to a max of 4 sprays every 1.5 hours as needed
Lidocaine ointment 5%, 15g tube, rub sparingly and gently onto dried affected area
Lidocaine spray 10%, 50ml, apply as necessary with a cotton bud
Topical corticosteroids
12+ years
Drug prescribed
Clenil Modulite 50micrograms/metered inhalation (beclometasone pressurised inhalation CFC-free), One 200-dose unit, 1-2 puffs directly onto ulcers twice daily
Betamethasone 500micrograms soluble tablets, 100 tablets, 1 tablet dissolved in 10ml water as a mouthwash four times daily. Spit out mouthwash after rinsing
Hydrocortisone oromucosal tablets 2.5mg, 20 tablets, 1 tablet dissolved next to lesion four times daily
2-12 years
Drug prescribed
Clenil Modulite 50micrograms/metered inhalation (beclometasone pressurised inhalation CFC-free), One 200-dose unit, 1-2 puffs directly onto ulcers twice daily
Dry mouth
Artificial saliva
Drug prescribed
Artificial saliva gel, 50g, apply to oral mucosa PRN
Artificial saliva oral spray SF, 100ml, Spray PRN
Artificial saliva pastilles SF, 50 pastilles, 1 pastille sucked PRN
AS Saliva Orthana oral spray, 50ml, Spray three times onto oral mucosa PRN
BioXtra Gel, 40ml, apply to oral mucosa PRN
Glandosane Aerosol spray, 50ml, Sprayed onto oral and pharyngeal mucosa PRN (Not suitable for dentate patients due to pH)
Saliva stimulating tablets SF, 100 tablets, 1 tablet sucked PRN
Saliveze oral spray, 50ml 1 spray onto oral mucosa PRN
Topical fluoride
Drug prescribed
Fluoride toothpaste 0.619% (2800ppm), 75ml, Brush teeth for 1 minute after meals using 1 cm before spitting out twice daily. Avoid rinsing mouth, drinking or eating for 30 minutes after use.
Fluoride toothpaste 1.1% (5000ppm), 51g, Brush teeth for 3 minutes after meals using 2 cm before spitting out three times daily. Avoid rinsing mouth, drinking or eating for 30 minutes after use.
Fluoride mouthwash 0.05%, 250ml, Rinse mouth once daily with 10ml for 1 minute and spit out preferably at a different time from brushing
Caries
Drug prescribed
Fluoride toothpaste 0.619% (2800ppm), 75ml, Brush teeth for 1 minute after meals using 1 cm before spitting out twice daily. Avoid rinsing mouth, drinking or eating for 30 minutes after use.
Fluoride toothpaste 1.1% (5000ppm), 51g, Brush teeth for 3 minutes after meals using 2 cm before spitting out three times daily. Avoid rinsing mouth, drinking or eating for 30 minutes after use.
Fluoride mouthwash 0.05%, 250ml, Rinse mouth once daily with 10ml for 1 minute and spit out preferably at a different time from brushing
Recording why you prescribed
An antibiotic without a recorded indication is the gap that gets picked up on audit. The reasons SDCEP recognises for prescribing rather than managing locally:
- Unable to provide dental treatment without pharmacological anxiety management.
- Unable to provide local measures due to patient phobia.
- Poor cooperation.
- Not technically able to intervene surgically.
- Evidence of cellulitis.
- Evidence of spreading infection.
- Evidence of systemic involvement.
- Patient is immunocompromised or high risk individual.
Local measures come first wherever they are possible. An antibiotic is an adjunct to drainage, extraction or endodontic treatment — not a replacement for any of them.