Dental Abscess

ICD-10 code: K04.7

Description
Medicine Treatment 
Referral 

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DESCRIPTION 

Acute or chronic suppuration related to teeth, due to infection. It is characterised by:

• acute, severe, throbbing pain.
• swelling adjacent to the tooth, or on the face.
• pain worsened by tapping on affected teeth.
• restricted mouth opening or difficulty chewing.
• pus collection located around the tooth or at the apex of the root.

MEDICINE TREATMENT 

Initiate treatment before referral:

Children

• Amoxicillin, oral, 10–20 mg/kg 8 hourly for 5 days.

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AND

• Metronidazole, oral, 7.5 mg/kg/dose 8 hourly for 5 days. See Dosing Tables.

Adults

• Amoxicillin, oral, 500 mg 8 hourly for 5 days.

AND

• Metronidazole, oral, 400 mg, 8 hourly for 5 days.

Severe penicillin allergy:

ICD-10 code: Z88.0

Children < 18 kg

• Macrolide, e.g.:
  • Azithromycin, oral, 10 mg/kg/dose, daily for 3 days. See Dosing Tables.

Children > 35 kg and adults

• Macrolide, e.g.:
  • Azithromycin, oral, 500 mg daily for 3 days.

Pain:

Children

• Paracetamol, oral, 10–15 mg/kg/dose 6 hourly when required. See Dosing Tables.

Adults

• Paracetamol, oral, 1 g 4–6 hourly when required to a maximum of 4 doses per 24 hours.
  • Maximum dose: 15 mg/kg/dose.
  • Maximum dose: 4 g in 24 hours.

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Note: Dental rinses are not recommended for prevention of Covid-19 transmission during dental procedures.

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REFERRAL

All cases for dental treatment.

LoE: IIIbⁱ

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Standard Treatment Guidelines and Essential Medicines List for South Africa, Primary Healthcare Level, Updated for the 2023 Edition