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In this article we will discuss about the drugs used for the treatment of oropharynx infections.
1. Mouthwashes, Gargles, and Dentifrices:
Mouthwash solutions prevent oral infections and are commonly used in patients undergoing dental treatment, for clearing mucus or cleaning the oral ulcers. Thymol is a mild antiseptic and one tablet dissolved in warm water is adequate mouthwash solution for most of the patients. Chlorhexidine gluconate is a more powerful antiseptic and used in a 0.2% solution (Corsodyl) for mouthwash and 1 % dental gel for children and handicapped patients. It has a specific effect in inhibiting the formation of plaque on teeth.
Hydrogen peroxide is useful in the treatment of acute ulcerative gingivitis (Vincent’s infection) since the organisms involved are anaerobes. It also has a mechanical cleansing effect due to frothing when it comes in contact with oral debris. Sodium perborate is similar in effect to hydrogen peroxide. Povidone-iodine mouthwash is useful for mucosal infections but does not inhibit plaque accumulation. There is no convincing evidence that gargles are effective.
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Oral ulceration and inflammation:
Simple mouthwashes (saline or thymol) and antiseptic mouthwashes (chlorhexidine or povidone-iodine) are often beneficial and accelerate healing of recurrent aphthae. Local anesthetic mouthwash (Benzydamine) or dental gel (Choline salicylate) may be effective in relieving the discomfort or oral ulceration.
Aphthous ulcers are small, painful, and recurrent those are common in healthy people. The cause is not known, but may be related to stress, and the treatment is only partly effective. Hydrocortisone lozenges, triamcinolone dental paste or tetracycline mouthwashes are used.
2. Oropharyngeal Anti-Infective Drugs:
Infections of pharynx and tonsils are very common and are usually viral and do not require any specific treatment. Serious throat infections require the use of appropriate antibiotic given systemically and there is little indication for the local use of antibiotics in these circumstances. Preparations administered in the dental surgery for the local treatment of periodontal disease include gels of metronidazole and of minocycline.
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Fungal infections, caused by Candida albicans, give rise to thrush and other forms of stomatitis and are generally a sequel to the use of broad-spectrum antibiotics or of cytotoxics. Of the antifungal antibiotics used for mouth infection, amphotericin and nystatin are not absorbed from the intestine, and are used by local application in the mouth.
Miconazole occupies an intermediate position, since it is used by local application in the mouth, but is also absorbed. Fluconazole and itraconazole are absorbed and are available for oral administration for oropharyngeal candidiasis. Herpes simplex and herpes labialis are treated by aciclovir suspension and cream.
