Gingivitis
Patients with a diagnosis of gingivitis
Long-term care for patients with a diagnosis of gingivitis aims to maintain the gingival tissues in a state of health after initial treatment to reduce inflammation has been delivered. It includes aspects of both prevention and treatment, with emphasis on regular re-enforcement of effective oral hygiene, management of modifiable risk factors (e.g. smoking status, diabetes control) and PMPR, where required.
Patients with a diagnosis of gingivitis are at increased risk of developing periodontitis (see Risk factors). Specific risk factors that suggest an increased risk of disease onset (e.g. age, inadequate oral hygiene, smoking, diabetes or a family history of early tooth loss) will shorten the risk-based recall interval compared to those with a diagnosis of periodontal health.
In patients who have a diagnosis of gingivitis but no history of periodontitis (i.e. no bone loss), each recall appointment should comprise assessment and, if appropriate, treatment as follows.
Update the patient’s medical and social history and assess the patient’s control of modifiable risk factors (e.g. plaque control, smoking status, HbA1c levels).
Carry out an oral examination, including periodontal screening (including BPE) and assessment of plaque and bleeding levels.
Provide personalised oral hygiene advice and instruction, where required, to assist and encourage the patient to improve their oral hygiene skills as well as their understanding of the value of good self-care routines (see Oral hygiene).
Where applicable, give advice on control of modifiable risk factors (see Smoking cessation and Control of diabetes).
Assess whether professional mechanical plaque removal (PMPR) is required, for example at sites where inflammation is present.
If PMPR is necessary, remove both supra- and subgingival plaque and calculus using an appropriate method.
Correct local plaque retentive factors - for example, remove overhanging restorations or alter denture design.
Assess and assign an individual periodontal risk level (see Assigning patient risk and Risk assessment tool) based on the patient’s medical history, known risk factors, current oral health status and levels of plaque control. Explain to the patient what this means for them and use the risk level to inform the future recall period.