Gingivitis

In all cases, patients should be advised to remove plaque on a daily basis with a soft or moderately soft toothbrush and to clean between the teeth with dental floss.

Brushing should be done in a small circular motion with the bristles directed towards the junction between the gum and tooth on the facial and lingual surfaces of the teeth.

Patients should expect minor bleeding with brushing, which will cease as gingivitis is resolved.

Regular check-ups with a dentist and tooth cleaning or debridement of the tooth surfaces by a dental hygienist or a dentist to remove plaque and dental calculus above and below the gum line are essential.

Patients with necrotising gingivitis should have co-existing risk factors treated where possible (e.g., smoking, diabetes mellitus, immunosuppression, stress, nutrition, substance use, HIV infection, and medicine use). Patients taking drugs that cause gingival enlargement (e.g., phenytoin, sodium valproate, ciclosporin A, calcium-channel blocking agents) or oral contraceptives (which increase gingival inflammation) should be counselled on drug replacement, where possible.