Gingivitis is a common gum disease that causes irritation, redness and inflammation of the gums. It is usually caused by plaque buildup on the teeth due to poor oral hygiene. If left untreated, gingivitis can progress to periodontitis and eventual tooth loss. The good news is gingivitis is reversible with professional treatment and good oral home care. There are also some medications that can help manage gingivitis symptoms and supplement professional dental treatments.
What Causes Gingivitis?
Gingivitis is caused by plaque, a sticky film of bacteria that constantly forms on the teeth. When plaque builds up, it irritates the gums and causes inflammation. Plaque hardens into tartar or calculus that adheres to the teeth above and below the gumline. Tartar can only be removed by professional dental cleaning. The bacteria in plaque produce toxins that cause chronic inflammation of the gums. As gingivitis progresses, the gums can become red, swollen and bleed easily. Factors that increase the risk of plaque buildup and gingivitis include:
– Poor oral hygiene − Inadequate brushing and flossing allows plaque to build up on the teeth.
– Smoking − Chemicals in smoke irritate the gums making them more susceptible to gingivitis.
– Hormonal changes − Hormonal fluctuations during puberty, menstruation, pregnancy and menopause can make gums more sensitive.
– Stress − High stress levels seem to increase vulnerability to gum disease.
– Medications − Some medications like oral contraceptives, antidepressants and heart medicines can affect oral health.
– Underlying disease − Conditions like diabetes and HIV may reduce resistance to infection making gingivitis more likely.
Progression of Gingivitis
There are three main stages of gingivitis:
– Mild gingivitis − Some redness, swelling and bleeding of the gums. No permanent damage to tissues or bone loss.
– Moderate gingivitis − More inflammation, bleeding, gum recession and formation of periodontal pockets. Early stages of tissue and bone damage.
– Severe gingivitis − Marked redness, swelling, bleeding, receding gums and loosening of teeth. Advanced destruction of periodontal tissues and supporting bone. At this stage, gingivitis has progressed to periodontitis.
If gingivitis becomes severe and left untreated, the supporting structures around the teeth can be destroyed. Teeth can loosen and fall out. That is why it is important to see a dentist at the first signs of gum disease. With early treatment, gingivitis progression can be halted and reversed.
Medications to Help Gingivitis
While professional dental cleanings, good oral hygiene and gum treatments are essential for treating gingivitis, some medications can also help reduce symptoms and infection. Medications commonly prescribed to manage gingivitis include:
Antiseptic Mouthwashes
Antiseptic and anti-plaque mouth rinses contain active ingredients like chlorhexidine gluconate, essential oils and cetylpyridinium chloride that have antibacterial and antiseptic properties. Using an antiseptic mouthwash daily helps control bacteria levels in the mouth and reduce plaque buildup that causes gingivitis. Some popular mouthwashes for gingivitis symptoms include:
– Peridex – Chlorhexidine gluconate
– Periogard – Chlorhexidine gluconate
– LISTERINE Antiseptic Mouthwash – Essential oils
– Crest Pro Health – Cetylpyridinium chloride
These prescription strength formulas should be used short term along with regular oral care. Rinsing with antiseptic mouthwash can reach areas a toothbrush cannot. While mouthwashes don’t take the place of brushing and flossing, they can help temporarily reduce bacteria to give inflamed gums a chance to heal. Follow product instructions for use.
Antibiotic Medications
In some moderate or severe cases, a dentist may prescribe antibiotics to treat gingivitis. Antibiotics like metronidazole, doxycycline, tetracycline and amoxicillin kill infection-causing bacteria and help reduce inflammation and destruction of gum tissues. Antibiotics may be prescribed if gingivitis symptoms persist after professional dental cleaning. The medication may come as antibiotic gel, rinse, ointment or pill. Antibiotics are usually used short-term along with oral hygiene instructions.
Corticosteroid Medications
Corticosteroids help control inflammation and are sometimes prescribed for ulcerative gingivitis that causes mouth sores and pain. These medications come as an oral rinse, tablet or topical ointment applied directly to inflamed gum tissues. Corticosteroids like dexamethasone or prednisone have immunosuppressant effects so they are generally only used for a couple weeks at a time. Possible side effects include oral thrush yeast infection.
Chlorhexidine Chip
The Periochip is a small biodegradable chip that contains the antibacterial agent chlorhexidine gluconate. The dentist inserts the tiny chip into the space between the tooth and gum. The chlorhexidine gets slowly released and controls bacteria around a tooth for up to three months. Periochips are sometimes placed after deep cleanings in patients prone to gingivitis. The medication gradually reduces infection and allows gums to heal.
Oral Analgesics
Over-the-counter pain relievers like acetaminophen, ibuprofen and naproxen sodium can temporarily relieve pain from inflamed gums caused by gingivitis. These medications reduce inflammation and may be taken short-term until gums start to heal. Prescription oral pain gels like benzocaine may also help numb discomfort.
| Medication | Uses |
|---|---|
| Chlorhexidine mouthwash | Kills bacteria, reduces plaque, manages inflammation |
| Doxycycline antibiotic | Fights and kills bacterial infection |
| Dexamethasone rinse | Controls severe gum inflammation |
| Periochip | Localized site delivery of chlorhexidine |
| Acetaminophen | Relieves minor gingivitis pain |
Proper Use of Medications for Gingivitis
While medications can supplement professional dental care, good at-home oral hygiene is still essential when treating gingivitis. Proper oral care habits like brushing twice a day, daily flossing and antiseptic mouth rinse can help reduce plaque that causes gingivitis. It is important to follow instructions carefully when using prescription strength mouth rinses containing chlorhexidine or essential oils. Do not eat or drink for 30 minutes after use. Long term overuse of these antiseptics can harm tooth enamel and irritate mouth tissues.
Consult a dentist or periodontist about the best medication options and oral hygiene plan for your gingivitis. Do not self diagnose or take someone else’s medications. Avoid overusing oral painkillers for gingivitis which can upset the stomach. Report any worrisome side effects from medications to your dentist right away. With professional treatment and proper at-home care, medications can help control gingivitis, allowing you to maintain good oral health.
Signs of Improving Gingivitis
It can take a few weeks after professional dental treatment and improved home care before inflammation and symptoms start improving. Signs that the gingivitis is responding to treatment and starting to get better include:
– Less redness and puffiness of the gums
– Gums bleed less when brushing
– Reduced gum sensitivity and pain
– Gum pockets getting shallower
– Less bad breath
– Teeth feeling tighter rather than loose
– Plaque buildup is reduced
– Need less dental anesthetic for procedures
– Comfortably tolerating firm brushing and flossing
Do not stop medications until completing the full course prescribed by your dentist even if symptoms improve. Stopping treatment too soon allows infection to rebound. Stay diligent with oral hygiene routines and regular dental cleanings. See the dentist right away if symptoms do not start improving within a few weeks to rule out any underlying health issues. Ongoing gingivitis increases the risk of permanent gum disease.
When to Seek Medical Care
In most cases, good oral hygiene and professional dental cleanings can resolve mild to moderate gingivitis. But prompt medical attention is needed if you experience:
– Severe gum pain that prevents eating, drinking or sleep
– Pus discharge from gums
– Receding swollen gums
– Loose teeth, changes in bite
– Persistent mouth sores or ulcers
– Bleeding gums that won’t stop
– No improvement with over-the-counter care
– Difficulty swallowing or opening mouth
– Fever, chills and ill feeling
Seek emergency care for symptoms like high fever, difficulty breathing or swelling of the face indicating a dental abscess. Some forms of gingivitis like acute ulcerative gingivitis require prescription medication. Have any non-healing sores or growths evaluated to rule out oral cancer. Sudden tooth sensitivity and pain can signify tooth decay or a cracked tooth needing repair. Let your dentist know if you have bleeding gums or pain lasting more than a few days. Prompt professional treatment can prevent gingivitis from worsening.
When to Expect Gum Disease Symptoms to Resolve
The time it takes gingivitis symptoms to improve depends on factors like:
– Severity of inflammation and infection
– Extent of plaque buildup present
– How well the patient complies with oral hygiene instructions
– If there are any underlying medical conditions
Mild cases of gingivitis caused only by surface plaque may resolve in a week or two with a dental cleaning and improved home care. When significant tartar deposits are present below the gumline, it may take a few dental visits to completely remove subgingival calculus. Moderate gingivitis often improves substantially in 2-4 weeks as inflammation subsides and healing begins.
However, it can take 3-6 months for the gums to fully recover and regain a healthy pink appearance. Pockets that form between teeth and gums take time to reattach and shrink back down. Some recession of gum tissues may be permanent in severe longstanding cases. Dentists will monitor gum health and adaptation during maintenance visits. If gingivitis symptoms related to plaque buildup have not improved in 4-6 weeks despite treatment, further evaluation is needed.
Preventing Recurrence of Gingivitis
Getting gingivitis once unfortunately increases susceptibility for repeat episodes if home care habits do not change. Here are some tips to help prevent gingivitis from recurring:
– Brush properly twice a day for 2 minutes, especially along the gumline
– Floss thoroughly once daily to remove plaque between teeth
– Have regular professional cleanings every 6 months
– Swish daily with antiseptic mouthwash to reduce bacteria
– Limit sugary snacks and acidic drinks that damage enamel
– Drink plenty of water to help neutralize acid and rinse away food
– Don’t smoke and avoid secondhand smoke
– Take any medications as prescribed
– Get treatment for dry mouth if present
– Have gum disease risk factors treated promptly
– Visit your dentist as soon as you notice any gum irritation
– Improve stress management and diet for better overall health
With diligent daily oral hygiene and ongoing professional care, you can keep gingivitis from coming back and maintain healthy gums for life. Don’t neglect your gum health.
When to Visit Your Dentist for Checkups
To prevent gingivitis, adults should have a complete dental exam at least yearly. Those with previous gum disease, poor oral hygiene or ongoing health issues may need dental visits every 3-6 months. Schedule routine dental cleanings based on recommendations from your dentist. Be sure to contact the office right away if you notice possible symptoms of gingivitis like red, swollen, tender gums between regular visits.
See your dentist immediately if you experience any of the following:
– Bleeding when you brush or floss
– Receding, shrinking gums
– Persistent bad breath or foul taste
– Sensitive teeth and gums
– Painful chewing
– Loose teeth
– Changes in mouth sores, growths or pain
– Any signs of infection like fever, pus
Routine dental exams allow early detection and treatment before gingivitis can progress to more serious gum disease and destruction. Report any symptoms or concerns promptly. Your dentist will evaluate areas of concern, diagnose causes and recommend proper care. Professional cleanings, early treatment, and improving your daily oral hygiene are the keys to keeping your smile healthy.
Conclusion
While good oral hygiene is essential for preventing and treating gingivitis, medications can provide added benefits. Antiseptic and antibiotic mouthwashes, antibiotics, corticosteroids and pain relievers may be prescribed to reduce bacterial infection and control inflammation. However, medications should only be used short term and as advised by your dentist along with professional treatment. Maintaining diligent daily brushing and flossing and regular dental cleanings is vital for getting gingivitis under control, allowing gums to heal and keeping gum disease from recurring or worsening.
