Drug Prescribing For Dentistry

September 2014 Update Supplement to the November

2013 Update

The following update lists amendments to Drug Prescribing For Dentistry 2nd Edition (published
in August 2011), as a result of changes published in the British National Formulary (BNF) and
BNF for Children (BNFC) and is provided in addition to the November 2013 update. The section
numbers, section names and pages of the SDCEP guidance that are affected are provided together
with the relevant amendments.

It can be stored in the pocket at the rear of your copy of the guidance booklet to ensure you have
easy access to the most up-to-date advice. Alternatively, the amended drug regimen boxes can
be pasted into the booklet at the relevant section.

Please note that in the August 2014 update there were minor errors in the following locations:

4.3 & 4.4 The number of amoxicillin capsules to be prescribed for adults.

5.1 & 5.2 The last line of the footnote of the prescribing boxes.

The correct information is provided in this September 2014 update which supersedes
the August 2014 update.

This update and the November 2013 update are available on the SDCEP website:
www.sdcep.org.uk.

Recent Changes to Antibiotic Prescribing

The recommended child doses of amoxicillin were doubled in BNF 68 and BNFC 2014-15 in
order to align with common prescribing practices within the UK. This has been reflected in the
following updates to amoxicillin drug regimen boxes.

Refer to Appendix 1 of the BNF and BNFC for further details of drug interactions. 1
September 2014 Update Drug Prescribing For Dentistry

Section 4 Bacterial Infections

4.2 Dental Abscess
Page 27: the following replaces the drug regimen box for amoxicillin (updated doses for children).

An appropriate 5-day regimen is:

Amoxicillin Capsules, 500 mg For children:

Send: 15 capsules Amoxicillin Capsules, 250 mg, or Oral
Suspension*, 125 mg/5 ml or 250 mg/5 ml
Label: 1 capsule three times daily
6 months 1 year 125 mg three
times daily
15 years 250 mg three
times daily
512 years 500 mg three
times daily
1218 years 500 mg three
times daily

NB: The dose of amoxicillin should be doubled in severe infection in adults and children aged 12 - 18 years. In
severe infection in children aged 6 months to 12 years, the dose of amoxicillin should be increased up to 30
mg/kg (max 1 g) three times daily.
Amoxicillin, like other penicillins, can result in hypersensitivity reactions, including rashes and anaphylaxis,
and can cause diarrhoea. Do not prescribe amoxicillin to patients with a history of anaphylaxis, urticaria or
rash immediately after penicillin administration as these individuals are at risk of immediate hypersensitivity.
*Sugar-free preparation is available.
Updated September 2014, in line with BNF 68 and BNFC 2014-15 changes to amoxicillin doses for children.

Refer to Appendix 1 of the BNF and BNFC for further details of drug interactions. 2
September 2014 Update Drug Prescribing For Dentistry

4.3 Acute Necrotising Ulcerative Gingivitis and Pericoronitis

Page 32: the following replaces the drug regimen box for amoxicillin (updated doses for children).

An appropriate 3-day regimen is:

Amoxicillin Capsules, 500 mg For children:

Send: 9 capsules Amoxicillin Capsules, 250 mg, or Oral
Suspension*, 125 mg/5 ml or 250 mg/5 ml
Label: 1 capsule three times daily
6 months 1 year 125 mg three
times daily
15 years 250 mg three
times daily
512 years 500 mg three
times daily
1218 years 500 mg three
times daily

NB: The dose of amoxicillin should be doubled in severe infection in adults and children aged 12 - 18 years. In
severe infection in children aged 6 months to 12 years, the dose of amoxicillin should be increased up to
30 mg/kg (max 1 g) three times daily.
Amoxicillin, like other penicillins, can result in hypersensitivity reactions, including rashes and anaphylaxis,
and can cause diarrhoea. Do not prescribe amoxicillin to patients with a history of anaphylaxis, urticaria or
rash immediately after penicillin administration as these individuals are at risk of immediate hypersensitivity.
*Sugar-free preparation is available.
Updated September 2014, in line with BNF 68 and BNFC 2014-15 changes to amoxicillin doses for children.

Refer to Appendix 1 of the BNF and BNFC for further details of drug interactions. 3
August 2014 Update Drug Prescribing For Dentistry

September 2014 Update Drug Prescribing For Dentistry

4.4 Sinusitis
Page 33: the following replaces the drug regimen box for amoxicillin (updated doses for children).

An appropriate 7-day regimen is:

Amoxicillin Capsules, 500 mg For children:

Send: 21 capsules Amoxicillin Capsules, 250 mg, or Oral
Suspension*, 125 mg/5 ml or 250 mg/5 ml
Label: 1 capsule three times daily
6 months 1 year 125 mg three
times daily
15 years 250 mg three
times daily
512 years 500 mg three
times daily
1218 years 500 mg three
times daily

NB: The dose of amoxicillin should be doubled in severe infection in adults and children aged 12 - 18 years. In
severe infection in children aged 6 months to 12 years, the dose of amoxicillin should be increased up to
30 mg/kg (max 1 g) three times daily.
Amoxicillin, like other penicillins, can result in hypersensitivity reactions, including rashes and anaphylaxis,
and can cause diarrhoea. Do not prescribe amoxicillin to patients with a history of anaphylaxis, urticaria or
rash immediately after penicillin administration as these individuals are at risk of immediate hypersensitivity.
*Sugar-free preparation is available.
Updated September 2014, in line with BNF 68 and BNFC 2014-15 changes to amoxicillin doses for children.

Refer to Appendix 1 of the BNF and BNFC for further details of drug interactions. 4
 August 2014 Update

September 2014 Update Drug Prescribing For Dentistry

Section 5 Fungal Infections

5.1 Pseudomembranous Candidosis and Erythematous Candidosis
Page 36: the following replaces the drug regimen box for miconazole oromucosal gel (update
to treatment duration).

If drug treatment is required, an appropriate 7-day regimen is:

Miconazole Oromucosal Gel*, 24 mg/ml For children:

Send: 80 g tube Miconazole Oromucosal Gel*, 24 mg/ml
Label: Apply a pea-sized amount after food 26 years Apply a pea-sized amount
four times daily twice daily after food
618 years Apply a pea-sized amount
four times daily after food

NB: Advise patient to continue use for 7 days after lesions have healed.
Do not prescribe miconazole for patients taking warfarin or statins.
*Sugar-free preparation is available.
Updated September 2014, in line with BNF 68 and BNFC 2014 2015.

5.2 Denture Stomatitis

Page 38: the following replaces the drug regimen box for miconazole oromucosal gel (update
to treatment duration).

If drug treatment is required, an appropriate 7-day regimen is:

Miconazole Oromucosal Gel*, 24 mg/ml For children:

Send: 80 g tube Miconazole Oromucosal Gel*, 24 mg/ml
Label: Apply a pea-sized amount to fitting 26 years Apply a pea-sized amount
surface of upper denture after food to fitting surface of
four times daily upper denture twice
daily after food
618 years As for adults

NB: Advise patient to remove upper denture, apply gel sparingly to fitting surface and then reinsert.
Advise patient to continue use for 7 days after lesions have healed.
Do not prescribe miconazole for patients taking warfarin or statins.
*Sugar-free preparation is available.
Updated September 2014, in line with BNF 68 and BNFC 2014 2015.

Refer to Appendix 1 of the BNF and BNFC for further details of drug interactions. 5
August 2014 Update Drug Prescribing For Dentistry

September 2014 Update Drug Prescribing For Dentistry

Scottish Dental Clinical Effectiveness Programme

Update published September 2014

Scottish Dental Clinical Effectiveness Programme

Dundee Dental Education Centre, Frankland Building,
Smalls Wynd, Dundee DD1 4HN

Email scottishdental.cep@nes.scot.nhs.uk
Tel 01382 425751 / 425771
Website www.sdcep.org.uk