Gingivitis Treatment & Management

Updated: Jan 31, 2023
  • Author: James M Stephen, MD, FAAEM, FACEP; Chief Editor: Jeff Burgess, DDS, MSD  more...
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Approach Considerations

Patients with simple chronic gingivitis should be given nonurgent dental referral.

Patients with ANUG should be seen within 24-48 hours for reevaluation because of risk of local or systemic spread of infection.

In addition to antibiotic therapy, physical and mental stressors should be eliminated. Good oral hygiene is mandatory.

Consultation with a dentist is recommended.


Emergency Department Care

In simple chronic gingivitis, emergency department (ED) intervention is not needed.

In ANUG, patients usually only need pain management in the ED.

If signs of systemic infection (eg, fever, sepsis) or progression to gangrenous stomatitis (noma) with soft tissue or bone destruction are present, then patients will need intravenous antibiotics, and possibly imaging of the affected areas, but this complication is exceedingly rare.

Proper oral hygiene (including brushing and flossing) should be stressed. The patient should be referred to a dentist or periodontist.

General measures include the following:

  • Remove irritating factors such as plaque, calculus, and faulty dentures

  • Use a warm saline rinse



Regular oral hygiene that includes brushing the teeth with a power brush and flossing or using interdental brushes is the best prevention. Although mouth rinses do reduce bacterial counts in test subjects, no clear clinical advantages have been demonstrated. [24, 25, 2]

The use of a power toothbrush with rotating/oscillating motion is better than a manual brush.

Regular dental check-ups are important.