What is the treatment for gingivitis (inflammation of the gums)?

From the Guidelines

Gingivitis treatment should prioritize a combination of professional dental care and good oral hygiene practices at home, including the use of antimicrobial mouthwashes such as chlorhexidine or natural alternatives like triphala, arimedadi oil, or green tea, which have shown comparable effects in reducing plaque and gingivitis indices 1.

Key Components of Gingivitis Treatment

• Professional dental cleaning (scaling) to remove plaque and tartar buildup
• Brushing teeth twice daily with a soft-bristled toothbrush and fluoride toothpaste, focusing on the gumline
• Daily flossing to remove plaque between teeth
• Use of an antimicrobial mouthwash, such as:
  • Chlorhexidine (e.g., Peridex or PerioGard 0.12%) for 1-2 weeks
  • Natural alternatives like triphala, arimedadi oil, or green tea, which have shown promise in reducing plaque and gingivitis indices 1

Additional Recommendations

• Rinse with warm salt water (1/2 teaspoon salt in 8 ounces of water) several times daily for pain relief
• Avoid smoking and limit sugary foods and drinks
• If symptoms persist after 1-2 weeks of home care, consult a dentist to prevent progression to more serious periodontal disease

Evidence-Based Support

Studies have demonstrated the effectiveness of various mouthwashes in reducing plaque and gingivitis indices, including:

• Triphala mouthwash, which showed comparable effects to chlorhexidine in reducing gingivitis and plaque indices 1
• Arimedadi oil, which demonstrated significant reductions in plaque levels and gingival inflammation comparable to chlorhexidine 1
• Green tea mouthwash, which exhibited antibacterial and anti-inflammatory properties, and showed comparable effects to chlorhexidine in reducing plaque and gingivitis indices 1

From the Research

Gingivitis Treatment Options

• Scaling and root planing (SRP) is a common treatment for gingivitis, which involves removing plaque and tartar from teeth both above and below the gum line 2
• The use of chlorhexidine rinses as an adjunct to SRP has been shown to be effective in reducing gingivitis and plaque accumulation 3, 4
• Subgingival administration of 1% chlorhexidine gel has also been found to be an effective adjunct to SRP in the treatment of chronic periodontitis 5

Clinical Benefits of Gingivitis Treatment

• SRP and chlorhexidine rinses have been shown to reduce plaque accumulation, gingival bleeding, and probing depth 3, 4
• The combination of SRP and chlorhexidine rinses has also been found to lead to a better reduction in BANA-positive species, which are associated with periodontal disease 4
• The use of oxygen-releasing gel as an adjunct to SRP has been found to provide additional benefits in the management of chronic periodontitis, including greater reductions in probing pocket depth, clinical attachment level, gingival index, and bleeding on probing 6

Microbiological Effects of Gingivitis Treatment

• SRP and chlorhexidine rinses have been shown to lead to a reduction in microbiological parameters, including the frequency of BANA-positive sites 4
• The use of subgingival administration of 1% chlorhexidine gel has been found to reduce the colony-forming units of Porphyromonas gingivalis, Fusobacterium nucleatum, and Tannerella forsythia 5
• The combination of SRP and oxygen-releasing gel has been found to promote greater reductions in clinical parameters, including probing pocket depth, clinical attachment level, gingival index, and bleeding on probing 6