Plaque-Induced Gingivitis

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Introduction

• An inflammatory response of the gingivae to plaque bacteria
• The most common type is chronic marginal gingivitis

Clinical features

• Chronic gingivitis is asymptomatic, low-grade inflammation of the gingivae
• Gums become red slightly swollen and bleed on slight touch

Non-drug treatment

• Oral hygiene instructions
• Scaling and polishing
• Antiseptic mouthwashes e.g. chlorhexidine gluconate 2% three times daily for 1 - 2 weeks
  • Hexetidine mouthwashes to alternate with warm saline mouthwashes

Drug treatment

• Analgesics
  • Paracetamol
  • Adult: 1g orally every 8 hours for 3-5 days
  • Child:
    • 1-5 years: 125-250 mg
    • 6-12 years: 250-500 mg orally every 8 hours
• Antibiotics
  • Amoxicillin
  • Adult: 250 mg orally every 8 hours for 5 days
  • Child:
    • 1 month - 1 year: 62.5 mg orally every 8 hours for 5 days; dose doubled in severe infections
    • 1 - 5 years: 125 mg every 8 hours for 5 days
    • 5 - 12 years: 250 mg 8 hourly for 5 days
    • 12 - 18 years: 500 mg 8 hourly for 5 days; all doses doubled in severe infections
  • Metronidazole
  • Adult: 200 mg orally every 8 hours for 5 days
  • Child:
    • 1 - 3 years: 50 mg orally every 8 hours for 3 days;
    • 3 - 7 years: 100 mg every 12 hours for 3 days;
    • 7-10 years: 100 mg every 8 hours for 3 days

Notable adverse drug reactions, contraindications and caution

• Metronidazole: nausea, vomiting and metallic taste
• Metronidazole is contraindicated in pregnancy
• Avoid alcohol during treatment with metronidazole, and for at least 48 hours after treatment

Prevention

• Oral health education
• Scaling and polishing every six months