Primary prevention
Gingivitis can be prevented by effective daily mechanical oral hygiene procedures of tooth brushing and use of dental floss, or other mechanical means (e.g., interproximal brushes, single-tufted brushes) to remove the bacterial plaque (biofilm) that accumulates daily on the teeth.[39][40]
Routine scale and polish treatment is not as important as daily plaque removal; one review found that it makes little or no difference to gingivitis among adults without severe periodontitis.[41]
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The process of maintaining good oral hygiene is helped greatly by the use of an efficient modern toothbrush, whether it is manual or powered. Advances in both manual and powered toothbrushes have increased their ability to remove plaque, although the effectiveness of manual toothbrushes is still limited by the manual dexterity and skill of the user. To some extent, power toothbrushes have overcome this limitation with the added advantage that they have a tendency to help the patient to use a better brushing technique and increase the motivation to brush regularly. Clinical studies have also shown that the powered brushes with an oscillating/rotating action are significantly more effective than a manual toothbrush.[39][42]
Dentifrices also have an important role in the reduction of bacterial plaque by enhancing the mechanical scrubbing and cleaning action of the brush, and by delivering antimicrobial/antiplaque agents.[43][44] These agents, formulated in mouthrinse, spray, or gel, may also be used as adjuncts to oral hygiene by individuals with reduced manual skills or for those who are dependent on others to perform daily oral hygiene.[45]
As gingivitis is a strong predictor of developing periodontitis, prevention of gingivitis will reduce the risk of periodontitis.[39]
Secondary prevention
Continuing with good oral hygiene and bi-annual dental check-ups will reduce the risk of gingivitis returning. When compared with manual toothbrushes, powered toothbrushes with a rotation-oscillation action provide protection against gum inflammation in the long and short term and offer better plaque removal in the short term.[42] Professional intervention is required as an adjunct to self-performed oral hygiene when calculus or defective fillings prevent an individual from effectively removing dental plaque. If possible, elimination of predisposing factors is also very important to prevent recurrence of necrotizing gingivitis.
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