Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Clinical
  • Published:

UK Dental Medicines Advisory Service: questions asked by dentists - part 5: prescribing for oromucosal diseases and dry mouth

Abstract

The UK Dental Medicines Advisory Service (UKDMAS) provides advice to dentists and other dental healthcare professionals concerning the use of medicines and medical devices in dentistry. The commonly asked questions posed to the UKDMAS concerning medicines used for the management of oromucosal disease and dry mouth are discussed with answers supplemented by relevant information from clinicians. This article includes questions related to topical corticosteroids and analgesics used for oral ulceration, antifungal therapy and saliva replacement products.

Key points

  • The UK Dental Medicines Advisory Service (UKDMAS) provides advice to dentists and other dental healthcare workers on the prescribing of medicines, and the use of medicines and medical devices in dental practice.

  • Highlights some of the commonly asked questions posed by dentists or other members of the dental team to the UKDMAS, concerning prescribing for oromucosal disease and dry mouth. The answers given are supplemented by information provided by clinicians from a range of dental specialties.

  • Oral ulceration and candidosis, as well as dry mouth, are common problems encountered in dental practice. Dentists must be able to prescribe appropriately and safely in order to manage these conditions.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Joint Formulary Committee. Betamethasone. 2020. Available at https://bnf.nice.org.uk/drug/betamethasone.html (accessed March 2020).

  2. Joint Formulary Committee. Beclometasone Diproprionate. 2020. Available at https://bnf.nice.org.uk/drug/beclometasone-dipropionate.html#professionSpecificInformation (accessed February 2020).

  3. Joint Formulary Committee. Hydrocortisone. 2020. Available at https://bnf.nice.org.uk/drug/hydrocortisone.html (accessed February 2020).

  4. The British & Irish Society for Oral Medicine. Patient Information. 2020. Available at https://bisom.org.uk/clinical-care/patient-information/ (accessed June 2020).

  5. Randall C, Finn D J, Field E A. UK Dental Medicines Advisory Service: questions asked by dentists - part 1: prescribing regulations and medicines use. Br Dent J 2021; 231: 393-397.

  6. Joint Formulary Committee. Benzydamine hydrochoride. 2020. Available at https://bnf.nice.org.uk/drug/benzydamine-hydrochloride.html (accessed February 2020).

  7. Field E A, Longman L P (eds). Tyldesley's Oral Medicine. 5th ed. Oxford: Oxford University Press, 2005.

  8. Joint Formulary Committee. Doxycycline. 2020. Available at https://bnf.nice.org.uk/drug/doxycycline.html (accessed February 2020).

  9. Rudralingam M, Randall C, Mighell A J. The use of topical steroid preparations in oral medicine in the UK. Br Dent J 2017; 223: 633-638.

  10. Marsh P, Martin M. Oral Microbiology. 5th ed. Edinburgh: Churchill Livingstone, 2009.

  11. Ellepola A N, Samaranayake L P. Antimycotic agents in oral candidosis: an overview: 1. Clinical variants. Dent Update 2000; 27: 111-112, 114-116.

  12. McIntyre G T. Oral candidosis. Dent Update 2001; 28: 132-139.

  13. Joint Formulary Committee. Nystatin. 2020. Available at https://bnf.nice.org.uk/drug/nystatin.html (accessed March 2020).

  14. Joint Formulary Committee. Miconazole. 2020. Available at https://bnf.nice.org.uk/drug/miconazole.html (accessed February 2020).

  15. Joint Formulary Committee. Chlorhexidine. 2020. Available at https://bnf.nice.org.uk/drug/chlorhexidine.html#indicationsAndDoses (accessed March 2020).

  16. Joint Formulary Committee. Fluconazole. 2020. Available at https://bnf.nice.org.uk/drug/fluconazole.html (accessed February 2020).

  17. Pfizer Limited. Summary of Product Characteristics: Diflucan 150mg hard capsules. 2019. Available at https://www.medicines.org.uk/emc/product/1065/smpc (accessed June 2020).

  18. Joint Formulary Committee. Hydrocortisone with miconazole. 2020. Available at https://bnf.nice.org.uk/drug/hydrocortisone-with-miconazole.html (accessed February 2020).

  19. Joint Formulary Committee. Topical corticosteroids. 2020. Available at https://bnf.nice.org.uk/treatment-summary/topical-corticosteroids.html (accessed February 2020).

  20. Joint Formulary Committee. Fusidic Acid. 2020. Available at https://bnf.nice.org.uk/drug/fusidic-acid.html (accessed March 2020).

  21. Dhondt F, Ninane J, De Beule K, Dhondt A, Cauwenbergh G. Oral Candidosis: treatment with absorbable and non-absorbable antifungal agents in children. Mycoses 1992; 25: 1-8.

  22. Barkvoll B, Attramadal A. Effect of nystatin and chlorhexidine digluconate on Candida albicans. Oral Surg Oral Med Oral Pathol 1989; 67: 279-281.

  23. Black D J, Kunze K L, Wienkers L C et al. Warfarin-fluconazole. II. A metabolically based drug interaction: in vivo studies. Drug Metab Dispos 1996; 24: 422-428.

  24. Medicines and Healthcare products Regulatory Agency. Topical miconazole including oral gel: reminder of potential for serious interactions with warfarin. 2016. Available at https://www.gov.uk/drug-safety-update/topical-miconazole-including-oral-gel-reminder-of-potential-for-serious-interactions-with-warfarin (accessed February 2020).

  25. Scottish Dental Clinical Effectiveness Programme. Drug Prescribing for Dentistry (3rd ed). 2016. Available at http://www.sdcep.org.uk/wp-content/uploads/2016/03/SDCEP-Drug-Prescribing-for-Dentistry-3rd-edition.pdf (accessed February 2020).

  26. Ezad S, Cheema H, Collins N. Statin-induced rhabdomyolysis: a complication of a commonly overlooked drug interaction. Oxf Med Case Reports 2018; DOI: 10.1093/omcr/omx104.

  27. UK Medicines Information. Can miconazole oral gel be used by patients taking a statin? 2020. Available at https://www.sps.nhs.uk/wp-content/uploads/2019/08/UKMi_QA_Miconazole-and-statins_update_Aug-2019.pdf (accessed February 2020).

  28. Yap Y G, Camm A J. Drug induced QT prolongation and torsades de pointes. Heart 2003; 89: 1363-1372.

  29. Specialist Pharmacy Service. What issues should be considered regarding drug induced QT Prolongation? 2020. Available at https://www.sps.nhs.uk/articles/what-issues-should-be-considered-regarding-drug-induced-qt-prolongation/ (accessed June 2020).

  30. Brown P, Fox K, Field E A, Randall C. UK Dental Medicines Advisory Service: questions asked by dentists - part 4: prescribing of high-strength fluoride toothpastes and use of fluoride varnishes in dental practice. Br Dent J 2021; 231: 623-628.

  31. UK Medicines Information. What should be considered when choosing or prescribing saliva substitutes? 2020. Available at https://www.sps.nhs.uk/wp-content/uploads/2020/02/UKMI_QA_Saliva-Subsitutes_update_June-2019-1.pdf (accessed June 2020).

  32. Osailan S P R, Shirodaria S, Challacombe S J, Proctor G B. Investigating the relationship between hyposalivation and mucosal wetness. Oral Dis 2011; 17: 109-104.

  33. Villa A, Connell C L, Abati S. Diagnosis and management of xerostomia and hyposalivation. Ther Clin Risk Manag 2015; 11: 45-51.

  34. Public Health England: Delivering better oral health: an evidence-based toolkit for prevention (4th ed). 2021. Available at https://www.gov.uk/government/publications/delivering-better-oral-health-an-evidence-based-toolkit-for-prevention (accessed November 2021).

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to E. Anne Field.

Ethics declarations

No conflicts of interest to declare.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Finn, D., Randall, C. & Field, E. UK Dental Medicines Advisory Service: questions asked by dentists - part 5: prescribing for oromucosal diseases and dry mouth. Br Dent J 231, 689–695 (2021). https://doi.org/10.1038/s41415-021-3681-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41415-021-3681-9

Search

Quick links