Chronic gingivitis
First line therapy
- Personal plaque/calculus control and professional debridement essential
- Patient education and oral hygiene instruction
- Correction of plaque retentive factors, e.g. overcontoured crowns, open margins, caries, etc.
Unresponsive to above, add
| Empiric Therapy | Dose/Duration |
|---|---|
| Chlorhexidine gluconate 0.12% mouthwash | Rinse with 15mL PO for 30 seconds bid (after toothbrushing) x 3 weeks then reevaluate |
| Antibiotics not recommended |
- In refractory cases, evaluation of systemic factors recommended:
- diabetes
- pregnancy
- viral infection
- endocrine dysfunction
- vitamin deficiency/malnutrition
- reduced host defences (eg. HIV, blood dyscrasias, medication +/or radiation therapy induced)
- xerostomia
- smoking
- In refractory cases, desquamative gingivitis should be differentially diagnosed from mucocutaneous disorders such as:
- lichen planus
- pemphigus
- cicatrical pemphigoid
- squamous cell carcinoma.