What is the treatment for a gum infection?

Treatment for Gum Infection

The primary treatment for gum infection includes proper oral hygiene with brushing four times daily using a soft toothbrush, daily interdental cleaning, and alcohol-free antimicrobial mouth rinses, combined with professional dental intervention when necessary. 1

Oral Hygiene Measures

• Brush teeth and gums four times a day using a soft toothbrush and fluoride-containing, non-foaming toothpaste 1
• Clean between teeth once daily using appropriate interdental cleaners (floss for healthy gums, interdental brushes for accessible spaces) 1, 2
• Rinse mouth with an alcohol-free mouthwash at least four times daily after brushing for approximately 1 minute with 15 ml of solution 1
• Maintain optimal nutritional support throughout treatment 1
• Inspect oral mucosa daily for signs of worsening infection 1

Professional Dental Intervention

• Surgical management is the first-line treatment for dental infections, including proper drainage of the infection site 3, 4
• Root canal therapy should be performed for salvageable teeth, while extraction is recommended for non-restorable teeth 3
• Incision and drainage must be performed for accessible abscesses 3, 4
• Mechanical debridement through scaling and root planing is essential to remove bacterial biofilm and calculus 4, 5

Antimicrobial Therapy

• Antibiotics should only be prescribed when there is systemic involvement (fever, malaise, lymphadenopathy) 3, 4
• Amoxicillin 500mg three times daily for 5 days is the first-choice antibiotic for acute dentoalveolar abscesses with systemic symptoms 4, 6
• For patients allergic to penicillins, clindamycin can be used as an alternative 4
• Antibiotics should never be used as a substitute for proper surgical intervention and drainage 3, 4

Mouthwash Options

• Chlorhexidine 0.2% mouthwash is effective in reducing plaque accumulation and gingival inflammation 1
• Herbal alternatives such as curcumin, triphala, green tea, and aloe vera mouthwashes have shown comparable effectiveness to chlorhexidine in reducing inflammation 1
• Use 10-15ml of mouthwash twice daily, rinsing for 1-2 minutes 1

Treatment Algorithm Based on Severity

For Mild Gingival Inflammation (Gingivitis)

• Implement enhanced oral hygiene measures (brushing, interdental cleaning, mouthwash) 1, 2
• Consider professional cleaning to remove plaque and calculus 5
• Follow up to ensure resolution of inflammation 2

For Moderate to Severe Infection (Periodontitis)

• Immediate professional dental evaluation 3
• Surgical intervention (scaling and root planing, possible incision and drainage) 3, 5
• Consider antibiotics only if systemic symptoms are present 3, 4
• Continue enhanced oral hygiene measures at home 1, 2

For Severe Infection with Systemic Symptoms

• Urgent surgical intervention to establish drainage 3, 4
• Prescribe appropriate antibiotics (amoxicillin 500mg TID for 5 days) 4, 6
• Consider hospital admission if there are signs of spreading infection or airway compromise 7
• Follow-up evaluation to ensure resolution of infection 4

Common Pitfalls to Avoid

• Prescribing antibiotics without performing proper surgical drainage is ineffective and contributes to antibiotic resistance 3, 4
• Delaying surgical intervention while waiting for antibiotics to take effect can lead to spread of infection 4
• Failure to address the underlying cause of periodontal disease will result in recurrence of infection 8
• Underestimating the severity of gingival infections can lead to delayed treatment of potentially life-threatening conditions 7

Special Considerations

• Dentures should be removed before performing oral care and cleaned thoroughly 1
• Avoid painful stimuli such as smoking, alcohol, spicy foods, and hot drinks during treatment 1
• Power toothbrushes are preferable as they are more effective than manual toothbrushes 5
• Patients should be advised to follow up with a dentist at least every 6 months 1