Antimicrobial Prescribing for General Dental Practitioners
Copyright FGDP(UK) 2014. No part of this publication may be reproduced without permission
The treatment of pericoronitis is by local measures. These include:
• Debridement and irrigation of accessible stagnation areas (abscesses may need incision and drainage).
• Occlusal adjustment to relieve occlusion, or extract opposing tooth if it is traumatising any inflamed pericoronal tissues.1
• Extraction of the impacted tooth, if there has been more than one episode, when infection is under control.2
Local measures are sufficient unless:1
• Temperature is raised.
• There is a spreading infection or severe localised infection or persistent swelling despite local measures.
• Trismus is present.
Metronidazole is the antimicrobial of choice as an adjunct to local measures. Amoxicillin is a suitable alternative where metronidazole is contraindicated.
The algorithm for managing pericoronitis is shown in Fig 3.
Metronidazole 400mg three times daily for up to five days, review after 2-3 days and discontinue if resolved5
Available on prescription as:
1. Faculty of Dental Surgery. National Clinical Guidelines 1997. London: The Royal College of Surgeons of England, 1997 (reviewed 2004).
2. National Institute for Health and Clinical Excellence. Technology Appraisal Guidance 1: Guidance on the extraction of wisdom teeth. London: NICE;2000.