Dawaa Reference

infectious

Gingivitis

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources4 sources

Corsodyl 0.2% Mouthwash SmPC sections 4.2 and 4.4 (eMC product 529) · Egyptian National Drug Formulary - Antimicrobial 2023 (phenoxymethylpenicillin monograph, odontogenic infection) · Metronidazole 200 mg Tablets SmPC section 4.2, acute ulcerative gingivitis (eMC product 12348) · Daley JO, Jain P. Gingivitis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan- . [Updated 2026 Jun 7]. Bookshelf ID: NBK557422. PMID: 32491354.

Verified against4 documents
  • Corsodyl 0.2% Mouthwash SmPC sections 4.2 and 4.4 (eMC product 529)
  • Metronidazole 200 mg Tablets SmPC section 4.2, acute ulcerative gingivitis (eMC product 12348)
  • Egyptian National Drug Formulary - Antimicrobial 2023 (phenoxymethylpenicillin monograph, odontogenic infection)
  • Daley JO, Jain P. Gingivitis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan- . [Updated 2026 Jun 7]. Bookshelf ID: NBK557422. PMID: 32491354.

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (3)

  • Gingivitis frequently causes no symptoms and can progress without the patient noticing
  • When symptoms occur, patients typically notice gum bleeding with brushing, flossing, or hard foods, plus bad breath that persists despite oral care [gum bleeding]
  • The chronic plaque-induced form is the commonest one; the forms are told apart by how they look, how long the infection has run, how severe it is and what caused it [plaques]

Signs — what you find (7)

  • Exam typically shows inflamed, tender gums that bleed easily with gentle probing
  • Gingival margins take on a knife-edge appearance, and normally stippled tissue becomes smooth and shiny
  • Probing depths beyond 3 mm without any attachment loss indicate a false pocket rather than periodontitis
  • Heavy plaque and calculus buildup on the teeth is a common finding
  • In the most severe swelling grade, the gum covers three-quarters or more of the tooth crown
  • It seldom bleeds of its own accord and is usually painless, which is why so many people never notice it and never come in [bleeding]
  • The inflammation stays in the soft tissue - the gingival epithelium and connective tissue - with no attachment loss and no migration of the junctional epithelium

Tests (1)

  • X-rays are not routinely needed but can help distinguish gingivitis from periodontitis when the picture is unclear

If not this — what else fits (1)

  • Periodontitis, unlike gingivitis, shows attachment loss detectable on periodontal probing

SourceStatPearls "Gingivitis" - disease-level clinical article

Presentation findings are traced to the source above.

Combination safety

Combination regimens

!! MULTI-DRUG REGIMEN - all 2 drugs are given TOGETHER. Not a choice between them.

!! the regimen: Metronidazole + Phenoxymethyl penicillin

1

CHLORHEXIDINE

1st line

Formmouth

Adult dose and duration

Rinse with 10 mL of 0.2% mouthwash for 1 minute twice daily - About one month for gingivitis, then review - the label sets that course length and expects the response to vary

Paediatric dose

Not for routine use in young children, who swallow mouthwash rather than spitting it out. Bleeding gums in a child are usually plaque or an erupting tooth - a dentist, not a mouthwash.

Dose source

Corsodyl 0.2% Mouthwash SmPC sections 4.2 and 4.4 (eMC product 529)

Why

Chlorhexidine suppresses the plaque bacteria that drive the gum inflammation, and gingivitis is a labelled indication for it. It buys control while the plaque itself is dealt with; it is not a substitute for scaling and brushing.

Cautions
  • This treats the inflammation, not the cause. Plaque removal by a dentist is the definitive treatment, and gums that keep bleeding despite good brushing need scaling.
  • Brown staining of the teeth and tongue is expected with courses of this length. It is reversible and comes off with dental cleaning, but warn the patient first or they will stop the treatment.
  • Taste is dulled while using it, and it can sting a sore mouth.
  • Toothpaste inactivates chlorhexidine. Rinse the mouth with water and leave a gap after brushing, rather than using them together.
  • Gums that bleed easily along with bruising, or with any other unexplained bleeding, is a blood problem until proved otherwise - check a full blood count.
Egyptian brands
Egyptian brandManufacturerIndicative price
ANTISEPTOL 1MG/ML MOUTH WASH 120 MLKAHIRA9.00 EGP
HEXITOL 1.25MG/ML MOUTH WASH 100 MLARAB DRUG COMPANY (ADCO)49.90 EGP
2

METRONIDAZOLE

Regimen: gingivitis-anug

1 of 2 - GIVE ALL TOGETHER

Formoral.solid

Adult dose and duration

200 mg three times daily x 3 days

Paediatric dose

The label gives age bands for acute ulcerative gingivitis, all for 3 days: 7-10 years 100 mg three times daily; 3-7 years 100 mg twice daily; 1-3 years 50 mg three times daily.

Dose source

Metronidazole 200 mg Tablets SmPC section 4.2, acute ulcerative gingivitis (eMC product 12348)

Why

For acute necrotising ulcerative gingivitis only - the painful, punched-out, bleeding interdental papillae with foul breath. That is an anaerobic infection and metronidazole is what covers it. Ordinary gingivitis needs no antibiotic.

Cautions
  • The antibiotic alone will not cure ANUG. It needs dental debridement; without it the disease comes straight back.
  • Facial swelling, trismus or fever is a spreading odontogenic infection, not gingivitis - that needs same-day dental or maxillofacial referral.
  • Egypt does not sell a 200 mg metronidazole tablet - the packs are 250 mg and 500 mg. The 200 mg above is the label's dose; giving 250 mg three times daily for 3 days is the substitution Egyptian practice makes, and that is a prescriber's decision rather than a labelled dose.
  • A metallic taste and furred tongue are common and not a reason to stop.
  • ANUG in a young adult who is otherwise well is usually smoking, stress and poor oral hygiene. ANUG that recurs or is severe should prompt an HIV test.
  • Strictly avoid alcohol and propylene glycol-containing products during treatment and for 3 days (72 hours) after the last dose - Egyptian National Drug Formulary, Antimicrobial 2023.
Egyptian brands
Egyptian brandManufacturerIndicative price
TRICHOGYL 250 MG 20 TAB.EL NASR4.35 EGP (0.22/unit)
DUMOZOL 500MG 20 F.C. TABS.MINA PHARM > ALPHARMA-DENMARK7.00 EGP (0.35/unit)
FLAGICURE 250MG 20 TAB.KAHIRA7.00 EGP (0.35/unit)
METRONIDAZOLE-MUP 250 MG 20 F.C. TABS.MUP11.00 EGP (0.55/unit)
METROZOLE 250MG 20 TAB.MEMPHIS20.00 EGP (1.00/unit)
TRICHOGYL 500MG 12 F.C.TAB.EL NASR15.00 EGP (1.25/unit)
GEDAZOLE 500MG 20 TAB.JEDCO INT. CO. FOR PHARMACEUTICALS34.00 EGP (1.70/unit)
METROGYPTON 500 MG 20 F.C. TABS.GYPTO PHARMA34.00 EGP (1.70/unit)
DUMOZOL 125MG/5ML SUSP. 125ML? strength differs? different route - not oral solidMINA PHARM > ALPHARMA-DENMARK5.75 EGP
METROZOLE 125MG/5ML SUSP. 120 ML? strength differs? different route - not oral solidMEMPHIS19.50 EGP
3

PHENOXYMETHYL PENICILLIN

Regimen: gingivitis-anug

2 of 2 - GIVE ALL TOGETHER

Strength500 mg

Formoral.solid

Adult dose and duration

500 mg every 6 to 8 hours for 5 to 7 days in combination with metronidazole x 5-7 days

Paediatric dose

25-50 mg/kg/day [child max 2000 mg]

(25 to 50 mg/kg/day in divided doses every 6 hours; maximum daily dose 2,000 mg/day.)

Dose by weight
3kg75-150 mg/day
4kg100-200 mg/day
5kg125-250 mg/day
6kg150-300 mg/day
7kg175-350 mg/day
8kg200-400 mg/day
9kg225-450 mg/day
10kg250-500 mg/day
11kg275-550 mg/day
12kg300-600 mg/day
13kg325-650 mg/day
14kg350-700 mg/day
15kg375-750 mg/day
16kg400-800 mg/day
17kg425-850 mg/day
18kg450-900 mg/day
19kg475-950 mg/day
20kg500-1000 mg/day
21kg525-1050 mg/day
22kg550-1100 mg/day
23kg575-1150 mg/day
24kg600-1200 mg/day
25kg625-1250 mg/day
26kg650-1300 mg/day
27kg675-1350 mg/day
28kg700-1400 mg/day
29kg725-1450 mg/day
30kg750-1500 mg/day
31kg775-1550 mg/day
32kg800-1600 mg/day
33kg825-1650 mg/day
34kg850-1700 mg/day
35kg875-1750 mg/day
36kg900-1800 mg/day
37kg925-1850 mg/day
38kg950-1900 mg/day
39kg975-1950 mg/day
40kg1000-2000 mg/day
41kg1025-2000 mg/day (upper capped)
42kg1050-2000 mg/day (upper capped)
43kg1075-2000 mg/day (upper capped)
44kg1100-2000 mg/day (upper capped)
45kg1125-2000 mg/day (upper capped)
46kg1150-2000 mg/day (upper capped)
47kg1175-2000 mg/day (upper capped)
48kg1200-2000 mg/day (upper capped)
49kg1225-2000 mg/day (upper capped)
50kg1250-2000 mg/day (upper capped)
Dose source

Egyptian National Drug Formulary - Antimicrobial 2023 (phenoxymethylpenicillin monograph, odontogenic infection)

Why

The Egyptian formulary pairs this with metronidazole for acute gingivitis of dental origin. It is a narrow-spectrum Access-group penicillin, which is the right first choice when an antibiotic is genuinely needed in the mouth.

Cautions
  • Take on an empty stomach - 1 hour before or 2 hours after food - or absorption drops.
  • Penicillin allergy is an absolute contraindication. Ask before prescribing, every time.
  • This is given with metronidazole, not instead of it.
  • Most gingivitis needs no antibiotic whatsoever. Reach for this only when there is necrotising disease or a spreading dental infection.
Egyptian brands
Egyptian brandManufacturerIndicative price
OSPEN 1.0 MIU 12 F.C.TABS.? strength differsSANDOZ24.00 EGP (2.00/unit)
OSPEN 1.5 MIU 12 F.C.TABS.? strength differsSANDOZ41.00 EGP (3.42/unit)

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.