Introduction
In clinical treatment of oral diseases, local medications are often required. Many chronic infections do not necessitate systemic medication and can be treated with local applications. Various anti-infective agents can be formulated into mouthwashes, films, ointments, and lozenges, and can also be made into sustained-release formulations. Besides being used on mucosal surfaces, they can also be applied in the pulp chamber and periodontal pockets, with several sustained-release agents successfully used in the treatment of periodontitis. Due to the complex oral environment, many factors affect the efficacy of anti-infective medications. The structure of dental plaque biofilm provides a high resistance to the drugs and host defense mechanisms for the microorganisms residing within.
▍Nystatin
Indications: Used for the treatment of the following conditions: (1) Oral candidiasis; this product can also be applied to the mucosal surface of dentures before wearing them. (2) Chronic oral mucosal lesions that are difficult to heal, such as pemphigus and erosive oral lichen planus, in conjunction with topical corticosteroid preparations. Precautions: (1) No therapeutic effect on systemic fungal infections; (2) Use with caution in pregnant and breastfeeding women. Contraindications: Allergic to this product.
Adverse Reactions: Oral administration of large doses may cause gastrointestinal reactions such as diarrhea, nausea, vomiting, and upper abdominal pain, which rapidly disappear after dose reduction or discontinuation.
Dosage and Administration: (1) Paste: For external use, apply an appropriate amount locally every 2-3 hours; after application, it can be swallowed; (2) Tablets: For lozenges, take 1-2 tablets at a time, three times a day.
Formulations and Specifications: Nystatin tablets: 500,000 U. Nystatin ointment: (1) 1g: 100,000 U; (2) 1g: 200,000 U.
▍Compound Chamomile and Lidocaine Hydrochloride
Indications: (1) For inflammatory pain of the gums, lips, and oral mucosa; (2) To relieve local symptoms during the eruption of primary teeth and wisdom teeth, as well as local symptoms caused by wearing orthodontic appliances; (3) As an adjunctive treatment for pain and discomfort associated with wearing dentures and for irritative and/or allergic reactions.
Precautions: Keep this product out of reach of children. Contraindications: Patients with known allergic reactions to any components of this product.
Adverse Reactions: Lidocaine may trigger delayed hypersensitivity reactions and immediate hypersensitivity reactions, and may cause cross-allergic reactions with other amide-type drugs; frequent local use of lidocaine, especially on mucosal surfaces, may trigger hypersensitivity reactions.
Dosage and Administration: (1) For inflammatory pain of the gums or oral mucosa: Apply about 0.5 cm of gel to the painful or inflamed gum area, gently massage, three times a day. (2) For symptoms or lesions related to wearing dentures: Apply about a pea-sized amount of gel to the affected area.
Formulations and Specifications: Compound Chamomile and Lidocaine gel: Each gram contains: Lidocaine hydrochloride 20 mg, Thymol 1 mg, Chamomile flower tincture 200 mg.
▍Aciclovir
Indications: For infections caused by herpes simplex or herpes zoster.
Precautions: (1) Use with caution in allergic individuals, pregnant and breastfeeding women; (2) This product is for skin and mucosal use only, not for the eyes; (3) Wear gloves when applying the medication; (4) If symptoms do not improve after 7 days of continuous use, consult a physician; (5) If there is a burning sensation, itching, redness, or swelling at the application site, discontinue use and wash the area; consult a physician if necessary.
Contraindications: Allergic to this product.
Adverse Reactions: Mild pain, burning, stinging, itching, and rash may occur.
Dosage and Administration: For external use, apply to the affected area; adults and children should apply every 2 hours during the day, six times a day, for 7 days.
Formulations and Specifications: Aciclovir cream: 3%.
▍Minocycline
Indications: For adjunctive treatment of periodontitis, periodontal abscess, and pericoronitis.
Precautions: (1) Monitor for allergic reactions; discontinue use immediately if signs of allergy (itching, redness, swelling, papules, blisters, etc.) occur; (2) Use with caution in elderly patients with liver dysfunction and severe renal impairment; (3) Injection may cause temporary irritation or pain at the injection site; slow injection can significantly reduce this symptom; (4) Remove soft debris, supragingival plaque, and calculus before administration; (5) Do not rinse or eat immediately after administration; (6) If local resistance or infection caused by insensitive bacteria occurs, discontinue use.
Contraindications: Patients with a history of allergy to tetracycline antibiotics.
Adverse Reactions: Local irritation may occur immediately after injection into the periodontal pocket but will subside quickly; this is a transient reaction.
Dosage and Administration: For external use, after periodontal flushing or basic periodontal treatment, inject the ointment deep into the periodontal pocket using a fine special syringe, once a week for 4 consecutive weeks.
Formulations and Specifications: Minocycline ointment: 0.5g: 10mg.
▍Dingpeng Emulsion
Indications: Suitable for toothache, gum bleeding, swelling, ulcers, and pus caused by acute and chronic gingivitis and stomatitis.
Precautions: Patients with necrotizing gingivitis or acute gingivitis should avoid brushing; the emulsion can be applied to the affected area.
Contraindications: Allergic to borax, clove oil, and eugenol.
Adverse Reactions: Rare allergic reactions may occur.
Dosage and Administration: For external use, apply an appropriate amount of emulsion to the affected area, 3-4 times a day. After leaving it on the affected area for 3-5 minutes, rinse with clean water. It can also be applied to a toothbrush for brushing. Using it before bedtime yields better results.
Formulations and Specifications: Dingpeng emulsion: contains clove oil, borax, etc.
▍Cydiodine Buccal
Indications: For chronic pharyngitis, oral mucosal ulcers, chronic gingivitis, and periodontitis.
Precautions: (1) Use with caution in pregnant and breastfeeding women; (2) Use with caution in patients with thyroid diseases; (3) Children should use under physician guidance; (4) If symptoms do not improve after 5 days of continuous use, discontinue and seek medical attention; (5) In case of overdose or severe adverse reactions, seek medical attention immediately.
Contraindications: Allergic to this product or other iodine preparations.
Adverse Reactions: (1) Rare allergic reactions such as rash and skin itching; (2) Long-term use may lead to tongue discoloration, which will disappear after discontinuation.
Dosage and Administration: For lozenges, take 1 tablet at a time, 3-4 times a day.
Formulations and Specifications: Cydiodine lozenges: 1.5mg (as iodine).
▍Dequalinium Chloride Buccal
Indications: For acute and chronic pharyngitis, oral mucosal ulcers, and gingivitis.
Precautions: (1) Use with caution in allergic individuals; (2) This product should be gradually dissolved in the mouth, do not chew; (3) In case of overdose or severe adverse reactions, seek medical attention immediately.
Contraindications: Allergic to this product.
Adverse Reactions: Rare allergic reactions such as rash; occasional nausea and gastrointestinal discomfort may occur.
Dosage and Administration: For lozenges, take 1-2 tablets at a time, every 2-3 hours, and may repeat as necessary.