Treatment - Gum disease (gingivitis and periodontitis)

The best way to treat gum disease is to practice good oral hygiene. But sometimes you'll need extra dental and medical treatments.

Good oral hygiene

Follow this advice to practice good oral hygiene.

Brushing your teeth

Brushing your teeth for about 2 minutes last thing at night before you go to bed and on 1 other occasion every day. It does not matter if you use an electric or manual toothbrush. But some people find it easier to clean their teeth thoroughly with an electric toothbrush.

Fluoride toothpaste

Use toothpaste that contains the right amount of fluoride. Fluoride is a natural mineral that helps protect against tooth decay.

Flossing

Floss your teeth regularly – preferably daily - before brushing your teeth. You could use interdental brushes instead.

Stop smoking

Smoking is one of the biggest risk factors for gum disease. Giving up smoking can greatly improve your oral hygiene.

If you need help or advice about giving up smoking, call the HSE's free stop smoking service on 1800 201 203.

Join the Quit plan and get support from trained stop smoking advisors

Dental appointments

Visit your dentist at least once every 1 to 2 years, but more often if you need to.

Mouthwash

Antiseptic mouthwashes containing chlorhexidine or hexetidine are available over the counter from pharmacies.

Mouthwashes cannot remove existing plaque. Only regular toothbrushing and flossing can do this.

Your dentist may recommend using mouthwash if it helps control the build-up of plaque. Plaque is the sticky substance that forms when bacteria collects on the surface of your teeth.

Your dentist will be able to advise you about which type of mouthwash is most suitable and how to use it.

Chlorhexidine mouthwash

Chlorhexidine mouthwash can stain your teeth brown if you use it regularly.

Rinse your mouth thoroughly between brushing your teeth and using a chlorhexidine mouthwash. Some ingredients in toothpaste can prevent the mouthwash working.

You should not use a chlorhexidine mouthwash for longer than 4 weeks.

Dental treatments

Some of the dental treatments described here may also be recommended if you have gum disease.

Scale and polish

A scale and polish is a "professional clean". It is usually carried out at your dental surgery by a dental hygienist.

The dental hygienist will scrape away plaque and tartar from your teeth. They will use special instruments, then polish your teeth to remove marks or stains.

If a lot of plaque or tartar has built up, you may need to have more than 1 scale and polish.

The price of a scale and polish can vary depending on what needs to be done. Ask your dental hygienist how much it'll cost beforehand.

Root planing

In some cases of gum disease, root planing (debridement) may be required.

This is a deep clean under the gums that gets rid of bacteria from the roots of your teeth.

Before having the treatment, you may need to have a local anaesthetic (painkilling medication) to numb the area.

You may experience some pain and discomfort for up to 48 hours after having root planing.

Further treatment

If you have severe gum disease, you may need further treatment, such as periodontal surgery.

In some cases, it's necessary to remove the affected tooth.

Your dentist will be able to tell you about the procedure needed and how it's carried out. If necessary, they can refer you to a specialist.

If you're having surgery or root planing, you may be given antibiotics (medication to treat infections). Your dentist will tell you whether this is necessary.

Treating acute necrotising ulcerative gingivitis

Acute necrotising ulcerative gingivitis (ANUG) should always be treated by a dentist.

But if you see your GP before visiting a dentist, they may provide you with some treatment while you wait to see your dentist.

Treatments for ANUG may also include antibiotics, painkillers and different types of mouthwash.

Antibiotics

Treatment with antibiotics, such as metronidazole or amoxicillin, may be recommended if you have ANUG. You'll usually have to take these for 3 days.

Amoxicillin is not suitable for people allergic to penicillin.

Metronidazole can react with alcohol, causing you to feel very unwell. Do not drink alcohol while you're taking metronidazole. Wait at least 48 hours after you finish your course of metronidazole before drinking alcohol.

Other side effects of metronidazole and amoxicillin can include:

• feeling sick
• vomiting
• diarrhoea

Painkillers

Paracetamol and ibuprofen are the most commonly prescribed painkillers.

They're also available over the counter from pharmacies. They may help reduce pain and discomfort.

But paracetamol and ibuprofen are not suitable for everyone. Read the manufacturer's instructions before taking them.

Mouthwash

Mouthwash containing chlorhexidine or hydrogen peroxide may be prescribed to treat ANUG.

Some chlorhexidine mouthwashes are also available over the counter. But they may not be as effective as a hydrogen peroxide mouthwash.

You should always read the instructions before using mouthwash. Some types may need to be diluted in water before they're used.