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Acute Necrotising Ulcerative Gingivitis

See guidance on dosing in children for quick reference dosage/weight guide.

Local measures are to be used in the first instance


Local Measures

  • Scaling, irrigation and oral hygiene advice

Treatment

  • As an adjunct to local measures metronidazole is the drug of choice. A suitable alternative is amoxicillin.
  • If antibiotics deemed clinically indicated.

First line Metronidazole**  Recommended duration 3 days

See guidance on dosing in children for quick reference dosage/weight guide.

Age Normal Dose
1-3 years 50 mg Susp TDS
3 - 7 years 100 mg Susp BD
7-10 years 100 mg susp TDS
10-18 years 200-250 mg TDS
Adult 400 mg TDS<

**Advise patients to avoid alcohol. The anticoagulant effect of Warfarin might be enhanced by Metronidazole3. Check for drug interactions before prescribing.

Products available: Metronidazole oral suspension 200mg/5ml, 200mg and 400 mg tablets


Alternative Amoxicillin*  Recommended duration 5 days

See guidance on dosing in children for quick reference dosage/weight guide.

Amoxicillin is as effective at treating dental infections as phenoxymethylpenicillin (Penicillin V) but is better absorbed.

Age

 Normal Dose

Maximum Dose

Maximum dose check (average weight for age)

1-11 months

125mg TDS

30mg/kg per dose to be given 3 times daily

1 month (4.3kg): 125mg 3 times daily
11 months (8kg): 250mg 3 times daily

1-4 years

250mg TDS

30mg/kg per dose to be given 3 times daily

1 yr (9kg): 250mg 3 times daily
4 yrs (16kg): 500mg 3 times daily

5-11 years

500mg TDS

30mg/kg per dose to be given 3 times daily

5 yrs (18kg) : 500mg 3 times daily
11 yrs (35kg): 1g 3 times daily

12-17 years

500mg TDS

1g 3 times daily

1g 3 times daily

Adult

500mg TDS

1g 3 times daily

1g 3 times daily

Please note: various strengths of Amoxicillin powder for suspension available:

  • 125mg/ 1.25ml
  • 125mg/5ml
  • 250mg /5ml

* Amoxicillin and phenoxymethyl penicillin, like other penicillins can cause hypersensitivity reactions including rashes and anyphalaxis and can cause diarrhoea. Do not prescribe to patients with a history of anaphylaxis, urticaria, rash immediately after penicillin administration as these patients are at risk of immediate hypersensitivity³ .Check for drug interactions before prescribing.


Patient Information

Visit HPSC Information Leaflets pages for the General Public, (MRSA, CRE, etc)


Reviewed Dec 2019

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