This guidance is not designed to be a definitive guide to oral conditions. It is for GPs for the management of acute oral conditions pending being seen by a dentist or dental specialist. GPs should not routinely be involved in dental treatment and, if possible, advice should be sought from the patient’s dentist.  When the patient is not registered with a general dental practitioner (GDP), advise they seek local registration or contact Dental Helpline, tel: 0845 644 2271.  For Out of Hours contact NHS 24.  Refer to GDP/Dental Helpline for follow up.

  • Antibiotics do not cure toothache. First line treatment is with paracetamol and/or ibuprofen; codeine is not effective for toothache. Scottish Antimicrobial Prescribing Group has developed an A4 poster for dental surgeries with this message. 
  • Chlorhexidine mouthwash is NOT recommended for the prevention of endocarditis in patients undergoing dental procedures.
  • Scottish Dental Clinical Effectiveness Programme (SDCEP) guidance Management of Acute Dental Problems is available in several formats including a downloadable app. This guidance provides decision support flowcharts to identify any immediate attention or advice to give to a patient and to determine the appropriate provider of subsequent care. 
  • Updated guidance on using phenoxymethyl penicillin for dental-alveolar infections has been published by SAPG. Local guidance in NHS Highland now reflects this.