Common brand names: Flagyl, Metryl.


Dental uses: Metronidazole is a synthetic antimicrobial agent originally introduced in the 1960s for the treatment of vaginitis. Its primary use in dentistry is in the treatment of infections caused by anaerobic bacteria (bacteria that do not require oxygen to survive). It is used alone in the treatment of a periodontal infection known as acute necrotizing ulcerative gingivitis (ANUG). It is combined with penicillin VK, amoxicillin or other antibiotics for the treatment of infected jaw fractures, various periodontal infections and endodontic infections.


Dosages for dental purposes: The typical adult dose of metronidazole is 250 milligrams to 750 milligrams every eight hours for seven to 10 days.


Concerns and possible side effects: Metronidazole produces a higher incidence of nausea, possibly accompanied by diarrhea, vomiting, and abdominal pain than does penicillin VK. It also produces a sharp, unpleasant metallic taste in some patients. Irritation and ulcers of the tongue, gingiva and other oral soft tissues occasionally occur in patients taking metronidazole.


Metronidazole should not be taken with alcohol or within three days of alcohol ingestion because the combination can produce headaches, facial flushing, heart palpitations, nausea and vomiting.


Metronidazole can increase the toxicity of certain drugs, including the manic-depressive medication lithium (Eskalith) and the blood-thinning agent warfarin (Coumadin). These interactions can be serious, so it is imperative to inform your dentist of all medications you are taking.

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