CHRONIC GINGIVITIS

Inflammatory infiltrate in response to the accumulation of undisturbed dental plaque next to the gingival margin

Causes

  • Mixed anaerobic and aerobic oral flora, e.g., Streptococcus viridans, facultative streptococci; fusiform bacteria,
    spirochaetes, viruses, fungi
  • Chemicals
  • Poor oral hygiene with increase in plaque accumulation

Clinical features

  • Swelling and erythema of the gingival margins which bleed on brushing
  • Plaque and calculus (tartar) deposits adjacent to the gingival margins

MANAGEMENT

General measures
Rinse mouth with mouthwash 3 times a day

  • Warm salt solution (5 ml spoonful of salt in 200 ml warm water)
  • Or hydrogen peroxide solution 6%, (add 15 ml to a 200 ml cup of warm water)
  • Or chlorhexidine solution 0.2%

Medicine

  • Paracetamol 1 g every 8 hours
    Child: 10-15 mg/kg every 8 hours
  • Or Ibuprofen 400 mg every 8 hours
    Child: 7-13 mg/kg every 8 hours

If systemic signs and symptoms present, give a 5-day course of an antibiotic:

  • Metronidazole 400 mg every 8 hours
    Child: 10-12.5 mg/kg (max 200 mg per dose) every 8 hours
  • Or Amoxicillin 500 mg every 8 hours
    Child: Amoxicillin Dispersible tablets 25 mg/kg every 8 hours
  • Refer to a dentist for scaling, root planing and polishing, to remove plaque and calculus deposits
Caution
  • Avoid metronidazole in 1st trimester of pregnancy