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Gingivitis & Periodontitis Management

Etiology

Poor oral hygiene, plaque accumulation, periodontal disease, tongue coating, xerostomia, candidiasis, and hormonal changes.

Clinical Presentation

Management Protocol

1. Initial Treatment (Non-Surgical)

  1. Oral hygiene education: Teach proper brushing and flossing techniques
  2. Plaque removal: Professional scaling and root planing
  3. Tartar removal: Remove all calculus deposits
  4. Antimicrobial rinse: Chlorhexidine 0.12% or Povidone-iodine rinse

2. Antibiotic Therapy

First-Line Antibiotics:
Antibiotic Dose Frequency Duration (Days)
Metronidazole 400mg Three times daily (TDS) 7-10 days
Amoxicillin 500mg Three times daily (TDS) 7-10 days
Amoxicillin + Clavulanic Acid 625mg (500+125) Three times daily (TDS) 7-10 days
Alternative Antibiotics (if allergic to above):
Antibiotic Dose Frequency Duration (Days) Indication
Clindamycin 300-400mg Three times daily (TDS) 7-10 days Penicillin allergy
Erythromycin 500mg Three times daily (TDS) 7-10 days Penicillin allergy
Azithromycin 500mg (Day 1), then 250mg Once daily 5 days total Macrolide option

3. Adjunctive Medications

Medication Dose Frequency Duration (Days) Purpose
Chlorhexidine Rinse 0.12% Twice daily 14-21 days Antimicrobial rinse
Povidone-Iodine Rinse 1% Twice daily 7-14 days Antimicrobial (if allergic to chlorhexidine)
Ibuprofen 400-600mg Three times daily 3-5 days Anti-inflammatory, pain relief
Paracetamol 500-1000mg Three times daily 3-5 days Pain relief (if NSAID contraindicated)

Nutritional Recommendations

Vitamin C (Ascorbic Acid) - Supports Collagen Formation & Immune Function
Food Source Portion Vitamin C Content Additional Benefits
Orange juice (fresh) 1 cup (240ml) 97mg Antioxidant, supports healing
Kiwi fruit 1 medium 64mg Enzyme aids digestion
Strawberries 1 cup (152g) 89mg Antioxidants, low glycemic
Guava 1 medium 165mg Highest Vitamin C, fiber rich
Bell peppers (raw) 1 cup (149g) 190mg Low calorie, versatile
Broccoli (cooked) 1 cup (156g) 101mg Calcium, anti-inflammatory
Zinc - Supports Immune Function & Wound Healing
Food Source Portion Zinc Content Additional Benefits
Oysters (cooked) 3 oz (85g) 74mg Highest zinc source
Beef (lean, cooked) 3 oz (85g) 7mg Iron, B vitamins
Pumpkin seeds 1 oz (28g) 8.5mg Magnesium, plant-based
Chickpeas (cooked) 1 cup (269g) 2.4mg Fiber, protein, affordable
Cashews (raw) 1 oz (28g) 1.6mg Healthy fats, magnesium
Calcium & Phosphorus - Supports Bone & Tooth Structure
Food Source Portion Calcium Content Additional Benefits
Milk (low-fat) 1 cup (240ml) 300mg Vitamin D fortified, protein
Yogurt (plain) 1 cup (245g) 300mg Probiotics, digestive health
Cheese (cheddar) 1 oz (28g) 204mg Protein, phosphorus
Leafy greens (spinach, cooked) 1 cup (180g) 245mg Iron, folate, low calorie
Almonds 1 oz (28g) 76mg Healthy fats, vitamin E
Beverages & Hydration
Beverage Portion Benefits Caution
Water (plain) 8-10 glasses daily Hydration, flushes toxins Essential for all healing
Green tea 1-2 cups daily Antioxidants, anti-inflammatory Caffeine content
Herbal tea (chamomile) 1-2 cups daily Calming, anti-inflammatory Caffeine-free
Bone broth 1 cup daily Collagen, minerals, amino acids Supports tissue healing
Foods to Avoid During Treatment

Follow-Up Care