The best way to treat gum disease is to practise good oral hygiene. But sometimes you'll need extra dental and medical treatments.
Good oral hygiene
Follow this advice to practise good oral hygiene.
Brushing your teeth
Brush your teeth:
- twice a day including last thing at night
- for 2 minutes each time
- with a manual or electric toothbrush - either brush can clean thoroughly
Fluoride toothpaste
Use toothpaste that contains fluoride. Fluoride is a natural mineral that helps protect against tooth decay.
Flossing
Floss your teeth:
- daily if you can
- before brushing your teeth
- using interdental brushes if you find floss hard to use
Stop smoking
Smoking is one of the biggest risk factors for gum disease and oral cancer. Giving up smoking can greatly improve your oral hygiene.
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 usually available in pharmacies, without a prescription.
Mouthwashes cannot remove plaque. Only regular brushing 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 tell you which type of mouthwash is best for you and how to use it.
Chlorhexidine mouthwash
Chlorhexidine mouthwash can stain your teeth brown if you use it regularly.
Some ingredients in toothpaste can prevent this mouthwash working. So wait 30 minutes between brushing your teeth and using the mouthwash.
Do not use a chlorhexidine mouthwash for more than 4 weeks.
Dental treatments
Your dentist may recommend a dental treatment if you have gum disease.
Scale and polish
A scale and polish is a professional clean. It is usually done by a dentist or hygienist at your dental surgery.
The hygienist will scrape away plaque and tartar from your teeth. They 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. Check with your dentist if you can have a free scale and polish on your PRSI or medical card.
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 and tartar or calculus from the roots of your teeth.
Before having the treatment, you may need to have a local anaesthetic (painkilling medicine) to numb the area.
You may have some pain and discomfort for up to 48 hours after having root planing.
Other treatment
If you have severe gum disease, you may need other types of treatment.
These can include:
- periodontal surgery to change the shape of your gums
- removal (extraction) of the affected tooth
Your dentist will talk to you about any procedure they think you need. They will explain how it is done. If necessary, they will refer you to a specialist.
If you're having surgery or root planing, you may be given antibiotics to treat infections. Your dentist will tell you if you need antibiotics.
Treating necrotising periodontal disease (NPD)
Necrotising periodontal disease (NPD) is an acute and painful infection of the gums and should be treated by a dentist.
Sometimes your GP will give you some treatment while you wait to see your dentist.
Treatments may include antibiotics, painkillers and different types of mouthwash. Once pain has been managed, most patients will need either scale and polish or root planing.
Necrotising periodontal disease
Antibiotics
You may be prescribed antibiotics for NPD. A course of metronidazole or amoxicillin is usually given. The course is usually for 3 days.
You cannot take amoxicillin if you are allergic to penicillin.
Do not drink alcohol while you're taking metronidazole. Wait at least 48 hours after you finish your course before having a drink. The medicine can react with alcohol, causing you to feel very unwell.
Other side effects of metronidazole and amoxicillin can include:
Painkillers
Paracetamol and ibuprofen are usually recommended to help ease pain and discomfort.
You can get these medicines without a prescription.
See the information leaflets that comes with the medicines before taking paracetamol and ibuprofen. Do not take them if you have a medical reason not to.
Mouthwash
Mouthwash containing chlorhexidine or hydrogen peroxide may be prescribed to treat NPD.
Some chlorhexidine mouthwashes are also available without a prescription. But they may not be as effective as a hydrogen peroxide mouthwash.
You should always read the instructions before using mouthwash. Some types need to be diluted in water before you use them.
Content supplied by the NHS and adapted for Ireland by the HSE
