Gingivitis Treatments and Medications

Healthy gums and connective tissue keep your teeth healthy and rooted in place. Swelling or bleeding of the gums may be symptoms of gingivitis. If you experience these issues, call a dentist before the condition evolves into a more serious gum disease. Learn more about the symptoms of gingivitis and how to treat it below.

What is gingivitis?

Gingivitis is swelling, redness, irritation, and bleeding of the gums. Called the gingivae, these gums are soft tissues that attach to and cover the necks of the teeth (and crowns of unerupted teeth). Along with deeper connective tissue, the gums help hold the teeth in place. Although symptoms may be mild, gingivitis is the first stage of gum disease (periodontal disease). Left untreated, gingivitis can evolve into more serious conditions and lead to tooth loss.

Gingivitis has many causes, but the most common is plaque build-up due to poor oral hygiene. It can also be caused by infections, allergic reactions, poor nutrition, pregnancy, and certain types of drugs, such as birth control pills, calcium channel blocker blood pressure medications, and the antiepileptic drug phenytoin.

Most gingivitis, however, results from plaque buildup. Dental plaque is a thin film that forms from food particles, saliva, and bacteria on the surface of teeth. Regular brushing of the teeth, flossing, and dental cleaning removes plaque and bacteria from the teeth. Poor dental hygiene, however, causes plaque to build up, harden into tartar, and creep up under the gums. When the immune system attacks bacteria colonies under the gums, this causes the swelling, redness, and irritation of the gums characteristic of gingivitis.

Left untreated, plaque builds up, separates the gums from the tooth, and creates gaps, or “pockets,” between the tooth and the gum tissues. As these pockets increase in size and the infection penetrates deeper tissues, gingivitis evolves into periodontitis, a serious condition that can ultimately lead to tooth and bone loss.

Gingivitis is one of the most common dental conditions in the world. Nearly 50% of adults aged 30 years and older have some form of periodontal disease, but it varies based on age, genetics, and lifestyle. Gingivitis is less common among young children and people with good dental hygiene. It is most common among adolescents and the elderly. While neglect and poor oral health are by far the major risk factors for gum disease, other risk factors include genetics, smoking, diabetes, pregnancy, crowded teeth, and dry mouth.

How is gingivitis diagnosed?

Gingivitis is primarily diagnosed by a visual examination of the gums. While dentists and dental hygienists primarily diagnose and treat gingivitis, more severe cases may be referred to a periodontist, a specialist in gum disease.

Many patients have mild or no symptoms and may not realize they have a problem with their gums. Even if the symptoms are mild, patients should talk to a dental professional if they notice signs of gingivitis, such as:

• Bleeding gums when brushing, flossing, or eating

• Bad breath that does not improve with brushing

• Swollen or receding gums

• Red gums

• Tender or sensitive gums

A dental professional diagnoses gingivitis based on the appearance of the gums and X-ray results. Early-stage gingivitis only affects the gingival tissue that lies between the teeth (the interdental papilla), while more severe gingivitis involves most of the gums overlying the crowns.

Lab tests are not necessary unless the dental professional suspects a more serious condition, such as periodontitis.

Gingivitis treatment options

Gingivitis treatment focuses on reducing inflammation, removing plaque, and adopting good oral care habits to prevent plaque buildup. Antiseptics and antibiotics may be required to control bacteria growth on the teeth and under the gums.

Lifestyle changes

If medications or poor nutrition are causing gingivitis, the initial treatment involves stopping or changing the medications, changing the diet, or prescribing supplements. Ask your doctor for advice on medications—do not stop or change medications on your own.

Oral hygiene

For all types of gingivitis, improving oral hygiene is a critical component of managing the condition. Teeth must be brushed and flossed regularly. The American Dental Association recommends brushing twice daily and flossing once daily.

Scaling and root planing (SRP)

Gingivitis is usually caused by plaque buildup, so the first-line treatment is scaling and root planing, or deep cleaning. Scaling removes the plaque below the gum line, and root planing smooths out the root’s surface to allow gum tissues to reattach to the tooth.

Medications

After deep cleaning, the dentist may prescribe antiseptic mouthwash, topical antibiotics, or antiseptics. For more severe infections or periodontitis, a dentist may prescribe a short course of oral antibiotics.

Gingivitis medications

The prevention and treatment of gingivitis are founded on good oral hygiene, which includes daily tooth brushing twice, mouth rinsing, and flossing to prevent or reduce plaque formation and bacteria. Severe cases may be treated with a short course of antibiotics.

Toothpastes and mouth rinses

The mainstays of gingivitis treatment are over-the-counter or prescription toothpastes or rinses containing antibacterial or anti-plaque agents. Brushing the teeth mechanically removes food particles, plaque, and bacteria from the tooth surface. Certain mouth rinses include ingredients that are effective at killing bacteria or preventing plaque buildup. For any mouth rinse to work effectively against bacteria, do not eat, drink, or brush the teeth 30 minutes after use.

Toothpastes and mouth rinses will contain one or more plaque- or bacteria-fighting ingredients, including:

• Essential oils: Several essential oils, including methyl salicylate (wintergreen), menthol, eucalyptol, and thymol, are mildly effective at fighting bacteria or relieving swollen gums. One or more of these ingredients are often included in over-the-counter toothpastes (Listerine Essential Care) or mouth rinses (Listerine) They may be effective at preventing gingivitis or treating early-stage gingivitis in patients with good dental health and excellent daily oral hygiene habits.

• Stannous fluoride: Added to toothpaste (Parodontax, Crest Pro-Health, and Crest Gum Detoxify) and mouth rinses (3M ESPE PerioMed) to help prevent tooth decay, the tin (stannous) in stannous fluoride is also a potent antibacterial agent that significantly prevents or reduces gingivitis. Prescription toothpaste and mouth rinses deliver a higher concentration of stannous fluoride than over-the-counter formulations.

• Chlorhexidine: A potent antibacterial agent, chlorhexidine is used by surgeons to disinfect their skin before operations. Chlorhexidine mouth rinses (Colgate Periogard, 3M Peridex, and GUM Paroex) are considered the most effective bacteria-killing mouth rinses. Brushing removes chlorhexidine from the teeth, so tooth brushing should be avoided for at least 30 minutes after rinsing.

• Cetylpyridinium chloride: Found in toothpaste (Colgate TotalCare) and mouth rinses (Crest Pro-Health Mouthwash), cetylpyridinium chloride (CPC) effectively kills bacteria that form on plaques. It is considered less effective than chlorhexidine.

• Hydrogen peroxide: Another potent antiseptic, hydrogen peroxide is frequently added to toothpaste (Arm & Hammer PeroxiCare) as a tooth whitener and to mouth rinses (Colgate Peroxyl and Orajel For Mouth Sores) to treat mouth sores. Hydrogen peroxide helps prevent or treat gingivitis, so some dentists recommend hydrogen peroxide products as part of daily gum treatment.

• Delmopinol: Classified as a medical device rather than a drug, delmopinol mouth rinse (GUM PerioShield) inhibits plaque formation and prevents bacteria from attaching to and congregating on plaque surfaces.

Topical antibiotics

After scaling and root planing, dentists may apply topical antibiotics—gels, chips, strips, or mini-capsules—to the teeth, gums, or under the gums. Containing minocycline, doxycycline, tetracycline, or metronidazole, these topical drugs slowly release antibiotics over time to the tooth and gum tissues to control bacteria growth and reduce pocket depth.

Oral antibiotics

A dentist may prescribe oral antibiotics for severe periodontitis, but only very rarely for gingivitis. Unlike topical antibiotics, oral (systemic) antibiotics have potentially hazardous side effects and risk producing drug-resistant bacteria. The one exception is acute necrotizing ulcerative gingivitis (ANUG), a severe form of gingivitis that requires a regimen of one or more oral antibiotics.

What is the best medication for gingivitis?

The best treatment for gingivitis is deep cleaning and correct daily dental hygiene. Toothpastes and mouth rinses sometimes contain agents that effectively fight off bacteria, inhibit plaque formation, and relieve pain and swelling of the gums. However, many have side effects, such as tooth staining, so the “best” medication is the agent or drug that helps restore gum health with a minimum of unwanted side effects.

Save big on your prescriptions

with the free SingleCare app.

4.8 average rating

Text a link to get the app

Send

Best medications for gingivitis