Antibiotics

in dentistry

;a- Severe inflammation

in child 2-in adult 3-in pregnant-1

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:Child 1

a. Lincomycin 600mg ( vial or ampoule) [ 1 mg x2x5 ]

or

b. Augmentin (156mg /312mg/) (syrup) [1x3x7]

]1x2x7[ ) syrup( ) mg 457 (

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Adult: a. Lincomycin 600mg (vial or ampoule) [2ml x2x5] or .2

b. Augmentin 625mg (tab) [1x3x7]

With or without

Metronidazole (200mg or 250mg or 500mg) or )*(

Alphintern……Unizen-fort……Avil )*(

c. Ceftriaxone 1g (vial) ( 1x2x5) [need sentivity test]

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:Pregnant and lactation .3

a. Amoxicillin 500mg (caps) [1x3x7]

 or

b. Augmentin 625mg ( tab ) [1x3x7] or (1gm) [1x2x7]

:b- Moderate inflammation

in child 2-in adult 3-in pregnant-1

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--
:in child-1

a)- Amoxicillin ( 125mg/250mg) syrup [1x3x7]

or

b)- Augmentin ( 156mg/312mg) syrup [1x3x7]

syrup ( 1x2x7) )mg 456 (

c)- Clindamycin ( 75mg ) syrup [1x4x4]

or

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:Adult .2
A. Amoxil (500mg) + Metronidazole (200mg/250mg/500mg)

Or

B. {Spiramycin (750,000 I.U) + Metronidazole 125mg }

)2x2x5( ).Spirazol----Spiragyl---Dentagyl----etc( -

)1x2x5( }Spiramycin 1.5 I.U + Metronidazole 250 mg{ ) Spiragyl- fort(-

C- Clindamycin (150mg) caps [1x4x4] or (300 mg) caps (1x3x4)

 Metronidazole (tab) if the case need +

: Pregnant and lactation .3

amoxicillin 500mg caps [1x3x7] )*(
spiramycin (1.5) I.U (1x4x7) )*(
Augmentin 1g (1x2x7) )*(

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:c- Mild inflammation

in child 2-in adult 3-in pregnant-1

=========================================================

:child -1
a- Amoxicillin (125mg/250mg) syrup [1x3x7]

b. Clindamycin {Dalacin-C} (75mg) syrup [1x4x4]

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-

:Adult .2
Amoxicillin (500mg) caps [1x3x7] )*(
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:Pregnant and lactation .3

Amoxicillin 500mg caps [1x3x7] )*(

*...Note :- Side effects of Clindamycin is (( pseudomembranous colitis))

:Pericoronitis)*(
Antibiotic ( Spirazol or Augmentin) + Mouthwash + Analgesics -1

Scaling if possible & Irrigation ( hydrogen peroxide + normal saline) .-2

Eludril, coxydil,hexadyl, Sensodyne;benzlagine -( Mouth wash ) e.x **-

. we can use Oracure (gel ) as local analgesic

· Pericoronitis (inflammation of soft tissue around impacted third molar is the most common cause of trismus.
· Trismus is the inability to normally open the mouth due to one or many causes.

Note -pregnant can take (mybacin (M.W) + Augmentin + Panadol (tab) --------> [not Panadol-extra]

Post-traumatic-*

After trauma :(( Amoxil , Augmentin or Clindamycin+ Analgesic) -*

.After Apicectomy or Surgical extraction -*
Clindamycin [150mg caps] or [300mg caps]

. Also the patient can take one of these medications beside the antibiotic

Antihistamine to decrease the edema such as Avil 25mg (1x2), or-*

Antitumefacient like: Serratiopeptidase enzyme i.e: Unizen- fort (10mg) -*

Danazen (5mg 1x3 ) or

Anti-inflammatory enzyme (Alphintern) tab (1x3x10) taken on empty stomach or before 1 -*

?hour or after 2 hours of meal…Why
Alphintern has a synergistic, anti-inflammatory and anti-edematous action of tow potent
proteolytic enzymes. Doctors advise taking the medication 1 hour before a diet or 2 hours after it
.since, the proteins in the food will degrade instead of that causing the tumor

:After scaling
:In severe cases .1

a. Tetracycline 500mg capsules And Metronidazole (500mg) tab [1x3x5]

b. Dentake-E / Dentaforce tab [1x3x30]

We use Tetracycline as mouth wash (Tetracaps 500mg ) because it increases the regeneration
of the gingiva which leads to increase the re-attachment of the gingiva to the tooth…. while the
…Metronidazole to kill the anaerobic bacteria

.In moderate cases: Metronidazole + Mouthwash+ Dentaforce .2

In mild cases: no need for antibiotics just Mouthwash .3

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Aphthous Ulcers
With some vitamins
Tetracaps 500mg (caps) + Salioct (oral paint)..*
containing minerals
such as muvit_cal
Tetracaps 500mg (caps) + Solcoseryl (dental adhesive paste)..*
1x1x30
.Silver Nitrate sticks gently painted on ulcer = chemical ..*

Some treatments options that may aid the healing process are :-
· In aphthous ulcer, topical or oral tetracycline suspension may be given.
· Steroid lozenges: It is used to reduce the pain, and may help ulcers to heal more quickly. A steroid lozenge
works faster.
· Chlorhexidine Mouthwash may reduce the pain. It may also help ulcers to heal more quickly. It also helps to
prevent ulcers from becoming infected. Chlorhexidine mouthwash is usually used twice a day.
· The use of benzydamine spray, or choline salicylate gel is very beneficial for the treatment of aphthous
ulcer.
· Aciclovir, a type of antiviral medication may sometimes be helpful for mouth ulcers caused by the herpes
 simplex virus.
· Where available, superficial tissue cauterization using Debacterol or use a silver nitrate stick
· Avoid products or food mostly acidic food, that you know trigger or exacerbate ulcers.
· Improve diet or take dietary supplements of vitamins or minerals that are effective for the treatment of
aphthous ulcer.
· Treatment of aphthous ulcers may include corticosteroids applied as a paste or used as a mouthwash..
· Steroid paste (gel) is an alternative to a lozenge.
· Numbing agents such as the local anaesthetics benzocaine and lignocaine (lidocaine) to help reduce pain.

Analgesics
Paracetamol for .1
a. dental pain

b. anti pyretic effect to reduce body temperature to the normal level for
. example : mumps , herpes infection , any infection

paracetamol is contraindication in liver disease and we have to decrease the dose with renal
disease

: Commercial names and dose

A. Ramal 500mg tab for adult 1x3

B .Amol 250mg tab for child 1x3

C. panadol syrup for children from 8 to 13 years 1x3

D. Paramol syrup for children under 6 years 1x3

!!!!! +E-Solpadine TAB paracetamol +codeine

NSAID .2
a. Ibuprofen

………commercial names and dose : Profinal , Broflam , Sapofen ,Novogent

Goven, Glofen (coated) we can use it with joint and TMJ pain

For adult 1x3 tab - For children from 12 to 15 years -

mg 1x3 200mg 1x3 tab 400

For children under 12 years 100 mg 1 x 3 syrup -

b- Mefanemic acid : Ponstan , Dysman , Fenamol

For adult the initial dose is 500mg after that 250mg \ 6 hours .*

We never prescribed it for children under 12 years .*

we never ever prescribe it for patient with peptic ulcer?? it may cause internal bleeding .*

For severe pain or strong anti-inflammatory drugs -

A . Declofenac – Na (ampoule) or (tablet)

mg 1x2 tab 75 mg I.M given each 12 to 24 hour 50- 25

) Used after traumatic surgery, in severe dental pain (

B . Declofenac –K ( Cataflam ) 1 x 3 tab

C . Diflonisal

Narcotic analgesics .3
A . Morphine ( 5-20 mg) ampoule I.M or S.C

Used after trauma, post operation ( major operation or for pain due to cancer

mg (1 x 3) tab ((cause addiction)) B. Tramadol 50

Or 100 mg (1x2) amp

.Used for severe pain when the patient has gastric ulcer and complaining of severe dental pain -*

.Alternative Analgesic for pregnant, peptic ulcer, renal failure patients -*

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)NOTES(

When the patient using night guard as a treatment of (T.M.J problems) or (to prevent the
destructive effects of grinding and clenching) we can prescribe these medications to help us in
…the treatment of such cases

.Ibuprofen 400mg (1x3) -*

.Diazepam 0, 5 tab (1x1x10) as muscle relaxant before sleeping -*

.Glucosamine (multivitamin) for joint (1x2x10) -*

:Multivitamins in dentistry
Child-*
.It must contain (Calcium, Vit. D3, Vit. A, Fluoride, Iron, and Phosphorous)

i.e : ( kiddi , Grand-vit )

-Kiddi ( multi-vit) syrup*1

Above 6 years (15ml) before breakfast

. Under 6 years (7.5 ml)

Grand-vit -2

.Above 6 years (10ml) twice daily

Under 6 years (5ml) twice daily

… Zymaflour: (sodium fluoride with D3) tab used sublingually -*

: Adult -*
Muvit-cal , Glovit ,( tab ) ( 1X1x30 )

Augmentain dose*
FREQUENCY DOSE AMOXCIL .CLAV
amount amount

1x3 mg syrup 156 125 31

1x3 312mg syrup 250 62

1x3 375mg tab 250 125

1x3 mg tab 625 500 125

 1x2 1000mg tab 750 250

1x2 g vial 1.2 1000 200

Note: On the first day of surgical extraction or apicectomy, I advise you to prescribe
…I.V Infusion to relieve the pain and to encourage wound healing

DNS i.e. (dextrose with normal saline ) .1

Vit B complex .2

Vit C .3

Plazil for nuesa .4

Dexamethasone .5

Ceftriaxone (1g) I.V .6

Voltarin I.v infusion .7

Zentac I.v .8

On the 2nd day, We can prescribe (Augmentin or clindamycin +Danazen or Alphintern +Analgesic)