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gingivitis

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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

Reference:

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

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