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Comprehensive Guide to FDA-Approved Drugs Used in Dentistry

This extensive guide covers a wide array of FDA-approved drugs commonly used in dentistry, including antibiotics, antifungals, antivirals, analgesics, anti-inflammatory drugs, and various other medications. The aim is to provide dental professionals with a detailed reference to enhance their clinical practice and optimize patient care.

1. Antibiotics

Antibiotics are essential in managing bacterial infections in dentistry. They are prescribed based on the type of infection, patient history, and potential drug interactions.

1.1 Infective Endocarditis Prophylaxis

Infective endocarditis (IE) is a serious infection of the heart valves or lining. Certain dental procedures can cause transient bacteremia, increasing the risk of IE in susceptible patients. The American Heart Association (AHA) recommends antibiotic prophylaxis for patients at high risk of adverse outcomes from IE, such as those with:

  • Prosthetic cardiac valves
  • History of infective endocarditis
  • Certain congenital heart diseases
  • Heart transplant with valve regurgitation

Recommended Antibiotics:

Generic Name(s) Class Dosage Indications
Amoxicillin Penicillin Antibiotic 2 g orally 1 hour before procedure High-risk patients with heart conditions
Clindamycin Broad-spectrum Antibiotic 600 mg orally 1 hour before procedure Penicillin-allergic patients

1.2 Dental Abscess

A dental abscess is a localized collection of pus associated with a tooth. Antibiotics are used alongside drainage and removal of the source of infection.First-line Antibiotics:

Generic Name(s) Class Dosage Duration
Amoxicillin Aminopenicillin 500 mg every 8 hours 5-7 days
Penicillin V Penicillin Antibiotic 500 mg every 6 hours 5-7 days
Metronidazole Antimicrobial Drug 500 mg every 8 hours 5-7 days
Erythromycin Macrolide 500 mg every 6 hours 5-7 days

Second-line Antibiotics:

Generic Name(s) Class Dosage Duration
Amoxicillin/Clavulanic Acid Penicillin Antibiotic 875 mg/125 mg every 12 hours 5-7 days
Cephalexin Cephalosporin Antibiotic 500 mg every 6 hours 5-7 days
Clindamycin Broad-spectrum Antibiotic 300 mg every 6 hours 5-7 days
Clarithromycin Macrolide 500 mg every 12 hours 5-7 days
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1.3 ANUG, Periodontitis, and Pericoronitis

Acute necrotizing ulcerative gingivitis (ANUG), periodontitis, and pericoronitis are inflammatory conditions of the gums and surrounding tissues. Antibiotics are used to control infection and reduce inflammation.

Generic Name(s) Class Dosage Duration
Metronidazole Antimicrobial Drug 500 mg every 8 hours 5 days
Amoxicillin Aminopenicillin 500 mg every 8 hours 5 days

1.4 Sinusitis

Sinusitis can complicate dental infections, particularly in the upper teeth. Antibiotics are indicated for bacterial sinusitis.

Generic Name(s) Class Dosage Duration
Amoxicillin Aminopenicillin 500 mg every 8 hours 5-10 days
Doxycycline Tetracycline Antibiotic 100 mg every 12 hours 5-10 days

1.5 Other Dental Infections

Other dental infections may require specific antibiotics based on the type of bacteria involved.

Generic Name(s) Class Dosage Indications
Cephalexin Cephalosporin Antibiotic 500 mg every 6 hours Dental infections
Ciprofloxacin Fluoroquinolone Antibiotic 500 mg every 12 hours Severe infections
Doxycycline Broad-Spectrum Antibiotic 100 mg every 12 hours Periodontal infections

2. Antifungals

Antifungal medications are used to treat fungal infections of the oral cavity, such as candidiasis. These drugs work by inhibiting fungal growth or killing the fungal cells directly.

2.1 Oral Candidiasis

Candidiasis can manifest as pseudomembranous or erythematous forms. Treatment typically involves topical or systemic antifungals.

Generic Name(s) Class Dosage Duration
Fluconazole Antifungal Drug 100-200 mg once daily 7-14 days
Miconazole Oral Gel Antifungal Apply 2.5 mL 4 times daily 7-14 days
Nystatin Antifungal Drug 400,000-600,000 units 4 times daily 7-14 days

2.2 Angular Cheilitis

Angular cheilitis often requires topical antifungal treatment.

Generic Name(s) Class Dosage Duration
Miconazole Cream Antifungal Apply twice daily Until resolved
Sodium Fusidate Cream/Ointment Anti-inflammatory Apply twice daily Until resolved

3. Antivirals

Antiviral medications are essential in managing viral infections of the oral cavity, such as herpes simplex and herpes zoster.

3.1 Herpes Simplex Infections

Herpes simplex virus can cause recurrent oral and labial lesions. Antivirals are used to reduce the duration and severity of outbreaks.

Generic Name(s) Class Dosage Duration
Aciclovir Antiviral Drug 200 mg 5 times daily 5 days
Penciclovir Cream Antiviral Apply every 2 hours while awake 4 days

3.2 Herpes Zoster

Herpes zoster (shingles) requires prompt antiviral treatment to limit complications.

Generic Name(s) Class Dosage Duration
Aciclovir Antiviral Drug 800 mg 5 times daily 7 days
Valaciclovir Antiviral Drug 1 g 3 times daily 7 days

4. Analgesics and Anti-inflammatory Drugs

Pain management is a critical component of dental care. Analgesics and anti-inflammatory drugs are used to alleviate odontogenic pain and manage associated conditions.

Also read:  Pain to pain-free: Journey of local anesthetic delivery systems in dentistry

4.1 Odontogenic Pain

Odontogenic pain refers to pain originating from the teeth, jaws, or surrounding structures. Over-the-counter and prescription analgesics are used to manage this type of pain.

Generic Name(s) Class Dosage Duration
Paracetamol Analgesic 500-1000 mg every 4-6 hours As needed
Ibuprofen Analgesic 200-400 mg every 4-6 hours As needed
Aspirin Analgesic 325-650 mg every 4-6 hours As needed
Diclofenac NSAID 50 mg every 8 hours As needed

4.2 Pain from Dental Surgery

Post-operative pain management is essential for patient comfort after dental procedures.

Generic Name(s) Class Dosage Duration
Hydrocodone Analgesic 5-10 mg every 4-6 hours As needed
Diflunisal NSAID 500 mg every 12 hours As needed

5. Sedatives and Anxiolytics

Sedatives and anxiolytics are often used in dental procedures to manage anxiety and discomfort.

5.1 Dental Procedures

Sedatives help in calming patients during dental treatments.

Generic Name(s) Class Dosage Indications
Diazepam Benzodiazepine 5-10 mg orally 1 hour before procedure Anxiety management
Midazolam Benzodiazepine 1-5 mg IV or IM before procedure Sedation during procedures
Triazolam Benzodiazepine 0.25-0.5 mg orally before procedure Anxiety management

6. Miscellaneous Drugs

Various other medications are used in dentistry for specific conditions.

6.1 Dry Mouth

Cholinergic agonists can help stimulate saliva production in patients with dry mouth.

Generic Name(s) Class Dosage Indications
Cevimeline Cholinergic Agonist 30 mg orally three times daily Dry mouth (xerostomia)
Pilocarpine Cholinergic Agonist 5 mg orally three times daily Dry mouth (xerostomia)

6.2 Gum Bleeding

Management of gum bleeding may involve antibiotics and antiseptics.

Generic Name(s) Class Dosage Indications
Chlorhexidine Antiseptic Rinse with 15 mL twice daily Gum disease management
Clarithromycin Macrolide Antibiotic 500 mg every 12 hours Gum infections

6.3 Oral Ulceration and Inflammation

Oral ulcers and inflammation can be caused by various factors, such as trauma, infections, or autoimmune conditions. Topical and systemic agents are used to promote healing and reduce discomfort.

Generic Name(s) Class Dosage Duration
Chlorhexidine Mouthwash Antiseptic Rinse with 10 mL twice daily Until resolved
Benzydamine Mouthwash Anti-inflammatory Rinse with 15 mL every 1.5-3 hours Until resolved
Lidocaine Ointment/Gel Local Anesthetic Apply to affected area As needed

6.4 Temporomandibular Joint Disorders

Temporomandibular joint (TMJ) disorders can cause pain, limited movement, and joint sounds. Muscle relaxants and anti-anxiety medications are sometimes used to manage these conditions.

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Generic Name(s) Class Dosage Duration
Chlorzoxazone Muscle Relaxant 250-500 mg every 6-8 hours As needed
Cyclobenzaprine Muscle Relaxant 5-10 mg every 8 hours As needed
Diazepam Benzodiazepine 2-10 mg every 6-8 hours As needed

6.5 Dental Caries Prevention

Fluoride products are used to prevent dental caries and promote remineralization of tooth enamel.

Generic Name(s) Class Dosage Indications
Sodium Fluoride Cariostatic Agent 0.5% gel or varnish applied by dentist Caries prevention

6.6 Saliva Substitutes

Saliva substitutes are used to alleviate symptoms of dry mouth.

Generic Name(s) Class Dosage Indications
Saliva Substitute Various formulations As needed Dry mouth (xerostomia)

Conclusion

This comprehensive guide to FDA-approved drugs used in dentistry provides a detailed reference for dental practitioners. Understanding the pharmacological management of various dental conditions is essential for providing effective patient care. Always consider patient-specific factors, including allergies, comorbidities, and current medications, when prescribing any drug. Regularly consult updated clinical guidelines and pharmacological resources to ensure the best outcomes for patients.

Dental Emergencies

Dental emergencies require prompt treatment to alleviate pain and prevent complications. Dentists may prescribe various medications to manage these situations effectively.

Odontogenic Pain

Odontogenic pain refers to pain originating from the teeth, jaws, or surrounding structures. Over-the-counter and prescription analgesics are used to manage acute dental pain.Recommended Medications:

Generic Name(s) Class Dosage Duration
Paracetamol Analgesic 500-1000 mg every 4-6 hours As needed
Ibuprofen Analgesic 200-400 mg every 4-6 hours As needed
Aspirin Analgesic 325-650 mg every 4-6 hours As needed
Diclofenac NSAID 50 mg every 8 hours As needed

Dental Abscesses

A dental abscess is a localized collection of pus associated with a tooth. Antibiotics are used alongside drainage and removal of the source of infection.First-line Antibiotics:

Generic Name(s) Class Dosage Duration
Amoxicillin Aminopenicillin 500 mg every 8 hours 5-7 days
Penicillin V Penicillin Antibiotic 500 mg every 6 hours 5-7 days
Metronidazole Antimicrobial Drug 500 mg every 8 hours 5-7 days
Erythromycin Macrolide 500 mg every 6 hours 5-7 days

Second-line Antibiotics:

Generic Name(s) Class Dosage Duration
Amoxicillin/Clavulanic Acid Penicillin Antibiotic 875 mg/125 mg every 12 hours 5-7 days
Cephalexin Cephalosporin Antibiotic 500 mg every 6 hours 5-7 days
Clindamycin Broad-spectrum Antibiotic 300 mg every 6 hours 5-7 days

Oral Trauma

Dental trauma, such as avulsed teeth or lacerations, may require specific treatments.Medications for Oral Trauma:

Generic Name(s) Class Dosage Indications
Tetanus Toxoid Vaccine Single dose Unimmunized patients with dirty wounds
Amoxicillin Aminopenicillin 500 mg every 8 hours Prophylaxis for high-risk patients
Chlorhexidine Antiseptic Rinse with 10 mL twice daily Wound irrigation and maintenance

Remember, the choice of medication depends on the specific emergency, patient factors, and the dentist’s clinical judgment. Always consult reliable sources and consider the latest evidence-based guidelines when managing dental emergencies.

Author

Dr Rockson BDS, PgDM, DBM (Germany) & Awarded Content Marketeer of the year 2020 & Love telling story for brands.

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