Embarrassing Illnesses

One of the best ways to treat gingivitis and periodontitis is to practice good oral hygiene. You can do this by:

• brushing your teeth twice a day (in the morning and last thing at night),
• flossing daily, and
• not smoking.

If possible, it is best to use an electric toothbrush to clean your teeth. You should also try using fluoride toothpaste if your water supply is low in fluoride. Fluoride is a natural mineral, which helps to strengthen your tooth enamel, protecting it from tooth decay.

As part of your treatment programme, you may also be prescribed an antiseptic mouthwash spray or gel which you will usually have to use for one month. The most commonly prescribed mouthwashes are chlorhexidine and hexetidine. A lot of these antiseptic solutions can be bought over-the-counter (OTC), and your GP or dentist can advise you on which is the best to use.

To make sure that plaque and tartar do not build up on your teeth, you may be advised to visit your dentist, so that your teeth can be 'scaled and polished'. This procedure involves having plaque and tartar scraped away with a special instrument, before being polished to remove blemishes and stains.

Some more severe cases of periodontitis may require a short course of antibiotics to help treat your infected gums. The most commonly prescribed antibiotics include metronidazole and doxycycline. You will normally have to take these antibiotics three times a day, for three days. However, you should not take doxycycline if you are pregnant, or breastfeeding because it may damage your baby's bones. It can also cause the contraceptive pill to fail, so it is important to use an additional form of contraceptive (such as a condom) while you are taking the antibiotic, and for seven days afterwards.

Acute necrotising ulcerative gingivitis (ANUG)

Acute necrotising ulcerative gingivitis (ANUG) should always be treated by a dentist. If you decide to see you GP before visiting your dentist, your GP may provide you with some treatment while you wait to see your dentist. This treatment may include:

• Antibiotics - metronidazole, or amoxicillin, are the most commonly prescribed antibiotics for ANUG. You will usually have to take these antibiotics for three days. Amoxicillin is not suitable for people who are allergic to penicillin. Women taking a contraceptive pill should be aware that amoxicillin can cause contraception to fail. You should therefore use additional contraceptive whilst taking amoxicillin, and for seven days afterwards.
• Analgesics - these medicines are more commonly known as painkillers, and may help to reduce the pain and discomfort caused by your ulcers. Paracetamol, or ibuprofen, are most commonly prescribed. However, ibuprofen is unsuitable for people with asthma. Children who are under 16 years of age should not take aspirin.
• Mouthwash (chlorhexidine or hydrogenperoxide)- these are special types of mouthwash which will help treat your infection. They are usually used two or three times a day.

As with gingivitis and periodontitis, you should continue to practice good oral hygiene. However, because ANUG can cause painful ulcers, you should brush your teeth with a very soft toothbrush, and should avoid using an electric brush. If a soft toothbrush is also too painful, you may want to consider using your finger covered in a soft cloth to clean your teeth. However, you should only clean your teeth in this way if it is too painful to use a conventional toothbrush.

Stopping smoking

Stopping smoking can greatly improve your oral hygiene. If you need help or advice about stopping smoking, you can call the free NHS Smoking helpline on 0800 169 0 169. Advice is available between 7am-11pm seven days a week. Your GP will also be able to advise you about smoking services in your local area.