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Gingivitis Treatment & Management

  • Author: James M Stephen, MD, FAAEM, FACEP; Chief Editor: Steven C Dronen, MD, FAAEM  more...
Updated: Jun 03, 2016

Emergency Department Care

See the list below:

  • In simple chronic gingivitis, ED intervention is not needed.
  • In ANUG, patients usually only need pain management in the ED.
  • If signs of systemic infection (eg, fever, sepsis) or progression to gangrenous stomatitis (noma) with soft tissue or bone destruction are present, then patients will need intravenous antibiotics, and possibly imaging of the affected areas, but this complication is exceedingly rare.
  • Proper oral hygiene (including brushing and flossing) should be stressed. The patient should be referred to a dentist or periodontist.
  • General measures
    • Remove irritating factors such as plaque, calculus, and faulty dentures.
    • Use a warm saline rinse.


See the list below:

  • Dentist
Contributor Information and Disclosures

James M Stephen, MD, FAAEM, FACEP Assistant Professor, Tufts University School of Medicine; Attending Physician, Director of Graduate Education, Department of Emergency Medicine, Tufts Medical Center

James M Stephen, MD, FAAEM, FACEP is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Chief Editor

Steven C Dronen, MD, FAAEM Chair, Department of Emergency Medicine, LeConte Medical Center

Steven C Dronen, MD, FAAEM is a member of the following medical societies: American Academy of Emergency Medicine, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Additional Contributors

Michael Glick, DMD Dean, University of Buffalo School of Dental Medicine

Michael Glick, DMD is a member of the following medical societies: American Academy of Oral Medicine, American Dental Association

Disclosure: Nothing to disclose.


Mark W Fourre, MD Associate Clinical Professor, Department of Surgery, University of Vermont School of Medicine; Program Director, Department of Emergency Medicine, Maine Medical Center

Disclosure: Nothing to disclose.

Robert J Lindberg; Special thanks to Robert J Lindberg, DMD, for images and excellent dental care.

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Healthy mouth and gingiva. Note the healthy light pink color of the gingiva. The intradental papillae are sharp and fill the intradental space. No local edema is present. Image courtesy of Robert J. Lindberg, DMD.
Moderate chronic gingivitis. Note that the papillae are edematous and blunted. They may bleed with brushing. Note areas of edema overlying some of the root areas. Pallor is seen in these areas. Image courtesy of Robert J. Lindberg, DMD.
Severe periodontal disease. Loss of the gingival tissue is seen, making the teeth appear long. Even more effacement of the papillae is present. Heaped up ridges are observed in the areas overlying the roots. Image courtesy of Robert J. Lindberg, DMD.
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