Gingivitis is inflammation of the gum from any cause, but it is most often associated with
plaque, the soft, sticky bacterial deposit that readily forms on exposed surfaces of teeth. It is easily removed by brushing and flossing, but if not it calcifies over time to form tartar (calculus), which results in a local inflammatory reaction, gingivitis.

CHLORHEXIDINE

Chlorhexidine mouthwash and spray (both 0.2%), or gel (1%), are the only OTC treatments for gingivitis. Chlorhexidine digluconate is a bisbiguanide antimicrobial agent, effective against a wide range of bacteria, viruses, fungi and yeasts. All presentations are licensed for use only in children over 12 years and adults. Chlorhexidine is safe for use during pregnancy and lactation.

Mouthwash

The mouth should be thoroughly rinsed for about one minute with 10ml twice daily.

Spray

Use up to 12 actuations of the spray directly to the affected areas, twice a day.

Gel

The teeth should be brushed thoroughly with one inch of gel on a moistened toothbrush for about one minute, once or twice daily.

Key points

• For all presentations, a course of treatment of about one month is recommended.
• Chlorhexidine is incompatible with anionic agents present in most toothpastes, so teeth should either be brushed and the mouth rinsed with water before using the preparations, or brushing and use of preparations should be at different times of day.
• Chlorhexidine preparations can cause superficial discoloration of the dorsum of the tongue, which disappears after treatment is stopped. Temporary discoloration of the teeth may also occur and can largely be prevented by reducing the consumption of tea, coffee and red wine and brushing with a conventional toothpaste daily before using the preparation.