skip to main content

Topical Corticosteroids in Dentistry — MFDS Part 1 MCQ

Instant feedback + full explanation. One question, done properly.

ModeratePharmacologyTopical Corticosteroids in DentistryMFDS Part 1

A 56-year-old woman has biopsy-confirmed oral lichen planus causing painful, widespread bilateral buccal mucosal erosions. Which corticosteroid regimen is appropriate for topical treatment of the oral lesions in UK practice?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Betamethasone sodium phosphate 500 microgram soluble tablet dissolved in water, used as a mouthwash and spat out

Betamethasone sodium phosphate 500 microgram soluble tablets may be dissolved in water and used off-label as a topical mouthwash for symptomatic oral lichen planus. The solution is rinsed around the affected mucosa and normally spat out; clear instructions are important because swallowing it increases systemic corticosteroid exposure. Prednisolone taken and swallowed and intramuscular dexamethasone are systemic treatments rather than topical oral therapy. Hydrocortisone skin cream is not formulated for intraoral use. Fluticasone can be used in specialist off-label oral regimens, but a nasal spray administered intranasally does not treat buccal lesions. Patients using topical oral corticosteroids should be reviewed for response and adverse effects, particularly oral candidosis.

Reference: Bristol, North Somerset and South Gloucestershire Area Prescribing and Medicines Optimisation Committee, Guide for Primary Care on the Use of Off-label Topical Steroids for Inflammatory Oral Conditions, Oral Lichen Planus section, approved 2023. https://remedy.bnssg.icb.nhs.uk/media/6432/gp-guide-inflammatory-oral-conditions-final.pdf