Gingivitis

Gingivitis is superficial gum inflammation recognised by the increased redness of the gums and bleeding on brushing.

Various causes of gingivitis include:

• poor oral hygiene
• periodontal disease
• phenytoin treatment
• scurvy
• acute myeloid leukaemia
• Vincent's angina
• localised trauma e.g. ill-fitting dentures, may result in local inflammation.

Management principles:

• temporary pain and swelling relief can be attained with saline mouthwash
• use antiseptic mouthwash:
  • if more severe and pain limits oral hygiene to treat or prevent secondary infection
    • e.g. Chlorhexidine 0.12 - 0.2% - rinse mouth for 1 minute BD with 5 ml diluted with 5 - 10 ml water (adult dose)
• primary cause for mucosal ulceration or inflammation (aphthous ulcers, oral lichen planus, herpes simplex infection, oral cancer) needs to be evaluated and treated
  
  
• if acute necrotising ulcerative gingivitis
  • commence metronidazole (adult dose 400mg tds for 5 days) and refer to dentist for scaling and oral hygiene advice
  • use in combination with antiseptic mouthwash if pain limits oral hygiene

Reference:

1. BNF 5.1
2. Public Health England (October 2014). Management of infection guidance for primary care for consultation and local adaptation