NUG and pericoronitis

NUG and pericoronitis

  • Local measures should be used in the first instance
  • Metronidazole is the drug of first choice where there is systemic involvement or persistent swelling despite local measures
  • A suitable alternative is amoxicillin
  • Before prescribing antibiotics, refer to the BNF or BNFC for drug interactions
  • Advise patients to space out doses as much as possible throughout the day

Necrotising ulcerative gingivitis (NUG) is a painful, superficial infection of the gingival margins associated with anaerobic fuso-spirochaetal bacteria and is more common in patients who smoke, the immuno-suppressed and those with poor oral hygiene. In mild cases of NUG, local measures may be sufficient but more severe cases may also require treatment with antibiotics, metronidazole being the drug of first choice.

Pericoronitis is a superficial infection of the operculum, with occasional local spread, that is often associated with anaerobic bacteria. In most cases treatment with local measures will be sufficient for resolution of the symptoms. However, where there is systemic involvement or persistent swelling despite local measures, a three day course of metronidazole can be prescribed.

A suitable alternative for both conditions is amoxicillin.