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Dental abscess - Management
Overview of management

  • Emphasize the need to seek dental treatment as soon as possible.
    • Advise the person when and where to seek urgent medical or dental intervention.
  • In the absence of immediate dental attention by a dental practitioner:
    • Provide appropriate self-care advice.
    • Advise the use of an analgesic to relieve symptoms.
      • Ibuprofen, or paracetamol if ibuprofen is contraindicated or unsuitable, is recommended first-line. See the CKS topic on NSAIDs - prescribing issues.
      • Paracetamol and ibuprofen can be taken together if pain relief with either alone is insufficient.
      • For adults, if taking paracetamol and ibuprofen together does not provide enough pain relief, consider adding codeine phosphate or switching to an alternative nonsteroidal anti-inflammatory drug (NSAID).
      • For women who are pregnant or breastfeeding, paracetamol is preferred. A short course of codeine may be added if paracetamol alone is insufficient.
    • Antibiotics are generally not indicated for otherwise healthy individuals when there no signs of spreading infection.
    • Only prescribe an antibiotic:
      • For people who are systemically unwell or if there are signs of severe infection (e.g. fever, lymphadenopathy, cellulitis, diffuse swelling).
      • For high risk individuals to reduce the risk of complications (e.g. people who are immunocompromised or diabetic or have valvular heart disease).
    • Do not routinely provide repeat prescriptions or switch antibiotics in people who fail to respond to first-line treatment. Instead advise the person to see a dental practitioner urgently.

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