Rapidly progressing Grade C disease (ONLY
DISEASE YOU PRESCRIBE ABX FOR IN PRACTICE)
Refer
urgently!
When rate of destruction is not consistent with local
factors
e.g optimal OH & no
calculus
You would refer this
though
Prescribe
for
Severe
ANUG
Periodontal
abscess
If local measures don't work
Rapidly progressing Grade C
disease
Refer too
Cases that haven't responded to
non-surgical management of perio
Refer too
Not stabilised after repeated courses of
RSI
Refer too
Notes
Must be as an adjunct to
RSI
Ideally after RSI
done
You want RSI to be completed in 7-14
days
Record patient compliance in
notes!!!!
What to prescribe? CHECK SDCEP
1. Metronidazole TABLETS 400mg TDS for
3 days (can be upto 5)
2. Amoxicillin CAPSULES 500mg TDS for 5
days
3b). Penecillin allergic patient 100mg doxycycline but
occasionally
VERY
SEVERE
Combination of metronidazole &
amoxicillin
3a) If you can't prescribe the first two
for periodontal conditions is
erythromycin or
clarithromycin/clindomycin NOT
tetracycline. 500mg once a day for 3
days
Who should i refer?
Rapidly progressing Grade C disease
MH affecting clinical
management
Head & neck
radiotherapy
IV
bisphosphonates
Immunocompromised
Bleeding disorder
Potential drug reactions
Unstable diabetes
Any pt's that have consistent pockets
>5mm with bleeding