Gum disease - treatment

Gum disease/treatment

The best way to treat gum disease is to practise good oral hygiene, although additional dental and medical treatments are sometimes necessary.

Good oral hygiene involves:

• 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


• using toothpaste that contains the right amount of fluoride, a natural mineral that helps protect against tooth decay


• flossing your teeth or using interdental brushes regularly – preferably daily, before brushing your teeth


• not smoking


• regularly visiting your dentist – at least once every 1 to 2 years, but more frequently if necessary

See the teeth cleaning guide for more information and advice about how to keep your teeth clean.

Mouthwash

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

But theres some debate about whether using mouthwash is necessary for people with healthy gums.

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, 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 can stain your teeth brown if you use it regularly.

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

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

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

Scale and polish

To remove plaque and tartar (hardened plaque) that can build up on your teeth, your dentist may suggest that you have your teeth scaled and polished.

This is a professional clean usually carried out at your dental surgery by a dental hygienist.

The dental hygienist will scrape away plaque and tartar from your teeth using 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 carried out, so ask your dental hygienist how much itll cost beforehand.

Find out more about NHS dental charges

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, its necessary to remove the affected tooth.

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

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

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.

As well as the oral hygiene advice and dental treatments mentioned above, 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. Youll 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. You should not drink alcohol while youre taking metronidazole and for 48 hours after you finish the course of treatment.

Other side effects of metronidazole and amoxicillin can include feeling sick, vomiting and diarrhoea.

Painkillers

Paracetamol and ibuprofen are the most commonly prescribed painkillers. 

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

But paracetamol and ibuprofen are not suitable for everyone, so read the manufacturers 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, though 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 theyre used.

Smoking is one of the most significant 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 free NHS Smokefree National Helpline on 0300 123 1044.

Your GP can give you information and advice about giving up smoking. You can also visit NHS Smokefree.