Necrotising Gingivitis

Local measures are to be used in the first instance, antibiotics should only be used if there is evidence of systemic involvement.

Local Measures

• Scaling, irrigation and oral hygiene advice.
• Recommend the use of 0.2% chlorhexidine mouthwash until acute symptoms are relieved.

Treatment

• As an adjunct to local measures metronidazole is the drug of choice where there is evidence of systemic involvement. A suitable alternative is amoxicillin.
• If antibiotics deemed clinically indicated:

Patient Information

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

Safe Prescribing (visit the safe prescribing page)

• Doses are oral and for adults unless otherwise stated
• Dosing in children quick reference dosage/weight guide
• Penicillin allergy – tips on prescribing in penicillin allergy
• Renal impairment dosing table
• Safety in Pregnancy and Lactation
• Drug interactions table. Extensive drug interactions for clarithromycin, fluoroquinolones, azole antifungals and rifampicin. Many antibiotics increase the risk of bleeding with anticoagulants.
• Visit the Health Products Regulatory Authority (HPRA) website for detailed drug information (summary of product characteristics and patient information leaflets). Dosing details, contraindications and drug interactions can also be found in the Irish Medicines Formulary (IMF) or other reference sources such as British National Formulary (BNF) / BNF for children (BNFC).

Reviewed Sept 2021