International Journal of Family Medicine

Research Article

A Focus Group on Dental Pain Complaints with General Medical Practitioners: Developing a Treatment Algorithm

Table 2

Antibiotics and pain relief for dental pain presenting to the general family practitioners [11].
Condition Antibiotic coverAnalgesic cover
Severe superficial infections with swelling and/or systemic signs and symptomsAmoxycillin 500 mg (child: 12.5 mg/kg up to 500 mg) orally, every 8 hours for 5 days 
OR 
Phenoxymethylpenicillin 500 mg (child: 12.5 mg/kg up to 500 mg) orally, every 6 hours for 5 days 
If allergic to penicillin 
Clindamycin 300 mg (child: 7.5 mg/kg up to 300 mg) orally, every 8 hours for 5 days		Paracetamol 1000 mg every 4 hours (max 4 g/day) (child: as per TG) 
OR 
Panadeine Forte (30 mg codeine, 500 mg paracetamol) every 6 hours (max 8 tabs/day)
Can be combined with 
Ibuprofen 200–400 mg every 4–6 hours as needed (max 2.4 g/day) (child: 4–10 mg/kg every 6–8 hrs, max 40 mg/kg)
Nonresponsive superficial infections with swelling and/or systemic signs and symptomsMetronidazole 400 mg (child: 10 mg/kg up to 400 mg) orally, every 12 hours for 5 days and phenoxymethylpenicillin 500 mg (child: 12.5 mg/kg up to 500 mg) orally, every 6 hours for 5 days 
OR 
Metronidazole 400 mg (child: 10 mg/kg up to 400 mg) orally, every 12 hours for 5 days and amoxycillin 500 mg (child: 12.5 mg/kg up to 500 mg) orally, every 8 hours for 5 days 
OR 
Amoxycillin + clavulanate 875 + 125 mg (child: 22.5 + 3.2 mg/kg up to 875 + 125 mg) orally, every 12 hours for 5 days 
If allergic to penicillin 
Clindamycin 300 mg (child: 7.5 mg/kg up to 300 mg) orally, every 8 hours for 5 days		Paracetamol 1000 mg every 4 hours (max 4 g/day) (child: as per TG) 
OR 
Panadeine Forte (30 mg codeine, 500 mg paracetamol) every 6 hours (max 8 tabs/day) 
Can be combined with 
Ibuprofen 200–400 mg every 4–6 hours as needed (max 2.4 g/day) (child: 4–10 mg/kg every 6–8 hrs, max 40 mg/kg)
Note: All patients with oral infection should be seen by a dentist within 2 or 3 days. If there is difficulty in breathing, swallowing, or opening the mouth, then urgent referral to ED is necessary and antibiotics will be given IV at the ED.