Last reviewed 01/2018

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

Varioius causes of gingivitis include:

  • poor oral hygiene
  • peridontal 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


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