Pericoronitis

Antimicrobial Prescribing for General Dental Practitioners
Copyright FGDP(UK) 2014. No part of this publication may be reproduced without permission

7 PERICORONITIS
REFERENCES


7 Pericoronitis

The treatment of pericoronitis is by local measures. These include:

• Debridement and irrigation of accessible stagnation areas (abscesses may need incision and drainage).
• Operculectomy.1
• 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

Adults

Metronidazole 400mg three times daily for up to five days, review after 2-3 days and discontinue if resolved5

Children
• 1-3 years: 100mg three times daily for up to five days, review after 2-3 days and discontinue if resolved
• 3-7 years: 200mg twice daily for up to five days, review after 2-3 days and discontinue if resolved
• 7-10 years: 200mg three times daily for up to five days, review after 2-3 days and discontinue if resolved
• Over 10 years: 400mg three times daily for up to five days, review after 2-3 days and discontinue if resolved

Available on prescription as:
• Metronidazole tablets 200mg
• Metronidazole oral suspension 200mg/5m

or

AMOXICILLIN
Adults
Amoxicillin 500mg three times daily for up to five days

Children
• Under 12 months old: 125mg three times daily for up to five days
• 1-5 years old: 250mg three times daily for up to five days
• 6-12 years old: 500mg three times daily for up to five days

Available on prescription as:
• Amoxicillin capsules 250mg
• Amoxicillin oral suspension (sugar-free) 125mg/5mL
• Amoxicillin oral suspension (sugar-free) 250mg/5mL

Figure 3

References

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.

Available for purchase individually or as a set of five.