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Dental abscess - Management
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Who should treat a dental abscess?

  • All people with a dental abscess should have definitive treatment provided by a dental practitioner.
  • Advise the person to access services (for emergency treatment) via:
    • Their registered Dental Practice, or
    • The Accident and Emergency department of a dental hospital (if available), or
    • The local Dental Access Centre (if available), or
    • The Accident and Emergency department of a district general hospital, if the airway is compromised or only if no other avenues are available.
  • Interim treatment by the medical practitioner may be needed while the person is waiting to see a dental practitioner.

In depth

What self-care advice should I recommend for dental abscess?

  • Consume cool, soft foods. Avoid food or drink that may be too hot or cold.
  • Encourage regular use of analgesics. Warn the person not to exceed the recommended or prescribed dose.

In depth

What analgesia is recommend for dental abscess?

  • Ibuprofen, or paracetamol if ibuprofen is contraindicated or unsuitable, is recommended first-line.
  • 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) such as naproxen or diclofenac.
    • In people at risk of cardiovascular adverse events, ibuprofen up to 1200 mg per day or naproxen up to 1000 mg per day are preferred to diclofenac.
  • For women who are pregnant or breastfeeding, paracetamol is preferred. A short course of codeine may be added if paracetamol alone is insufficient.

In depth

Should I prescribe an antibiotic for a dental abscess?

  • Only prescribe an antibiotic (amoxicillin or metronidazole up to 5 days):
    • 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).

In depth

When should I seek specialist advice or arrange hospital admission?

  • Seek further advice or admit a person to hospital if they have a dental abscess and:
    • Are unwell with a high temperature and cardio-respiratory compromise (rapid pulse rate or low blood pressure, high respiratory rate).
    • Early signs of dysphagia or a significant 'floor of mouth' swelling.
    • Are in severe pain despite analgesia (maximum tolerated dosage) prescribed in primary care.
    • Have a spreading facial infection.
    • Have a history of being immunocompromised.

In depth

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