Dental infections

All patients presenting with dental problems should get in contact with a dentist as soon as possible.

Inpatients: contact dental advice line on 01292 616990 to arrange for inpatient dentist review.

In hours (primary care):  contact usual dentist or, if unregistered, call the dental advice line on 01292 616990 (Monday to Friday 9am-5pm).

Out of hours (primary care):  NHS 24 on 111.

Toothache

Antibiotics are not recommended for toothache where there are no signs of infection.

The patient should contact their own dentist at the earliest opportunity. Or if not registered with a dentist, contact the dental advice line - see contact information above.

Dental abscess

Infection

Dental abscess - only consider antibiotics if there is evidence of cellulitis, spreading infection or systemic involvement
Antibiotic Therapy (before prescribing, carefully read the Notes / Comments section below)

First line:

Phenoxymethylpenicillin oral 500mg 6 hourly for 5 days

or

Metronidazole oral 400mg 8 hourly for 5 days

N.B. Stress that the patient must see a dentist as soon as possible.

Second line:

Patients who are felt to require second line treatments should be referred on to oro-maxillo-facial surgery.
Notes / Comments

The patient should contact their own dentist at the earliest opportunity. Or if not registered with a dentist, contact the dental advice line - see contact information above.

Seek advice from an oro-maxillo-facial surgeon if:

  • the swelling is increasing in size, or
  • the airway is threatened, or
  • the eye is occluded by swelling, or
  • there is evidence of systemic infection.

Dental abscesses present as swelling in the mouth and/or face originating from a tooth, often with pain.

Dental treatment is necessary to prevent infection recurring even if antibiotics are prescribed. 

Further advice on diagnosing and managing dental abscess can be obtained through the Scottish Dental Clinical Effectiveness online tool and A-Z of conditions.

Other dental conditions

Other acute dental problems may occasionally present to GPs or the Emergency Department and not all will require antibiotics.

For advice on recognising and managing other dental problems see Scottish Dental Clinical Effectiveness online tool and A-Z of conditions.

The patient should contact their own dentist at the earliest opportunity. Or if not registered with a dentist, contact the dental advice line - see contact information above.

 

 

Guideline reviewed August 2023
Page updated February 2024



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