# Gingivitis - Category: infectious - Review status: reviewed (every claim checked against a document named on this page) - 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 date: 2026-08 ## Verified against - 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. ## Treatment metadata - Chlorhexidine — mouth - Metronidazole — oral.solid - Phenoxymethyl penicillin — 500 mg — oral.solid ## Complete treatment card ```text GINGIVITIS 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. Review status: REVIEWED against 4 sources listed above (2026-08) 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 Source StatPearls "Gingivitis" - disease-level clinical article Status traced to the source above !! MULTI-DRUG REGIMEN - all 2 drugs are given TOGETHER. Not a choice between them. !! the regimen: Metronidazole + Phenoxymethyl penicillin 1. CHLORHEXIDINE [1st line] Adult 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 Peds 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. 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. Caution 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. Egypt ANTISEPTOL 1MG/ML MOUTH WASH 120 ML KAHIRA 9.00 EGP HEXITOL 1.25MG/ML MOUTH WASH 100 ML ARAB DRUG COMPANY (ADCO) 49.90 EGP 2. METRONIDAZOLE [1 of 2 - GIVE ALL TOGETHER] Adult 200 mg three times daily x 3 days Peds 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. 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. Caution 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. Egypt TRICHOGYL 250 MG 20 TAB. EL NASR 4.35 EGP (0.22/unit) DUMOZOL 500MG 20 F.C. TABS. MINA PHARM > ... 7.00 EGP (0.35/unit) FLAGICURE 250MG 20 TAB. KAHIRA 7.00 EGP (0.35/unit) METRONIDAZOLE-MUP 250 MG 20 F.C. TABS. MUP 11.00 EGP (0.55/unit) METROZOLE 250MG 20 TAB. MEMPHIS 20.00 EGP (1.00/unit) TRICHOGYL 500MG 12 F.C.TAB. EL NASR 15.00 EGP (1.25/unit) GEDAZOLE 500MG 20 TAB. JEDCO INT. CO... 34.00 EGP (1.70/unit) METROGYPTON 500 MG 20 F.C. TABS. GYPTO PHARMA 34.00 EGP (1.70/unit) DUMOZOL 125MG/5ML SUSP. 125ML MINA PHARM > ... 5.75 EGP -> ? strength differs, ? different route - not oral solid METROZOLE 125MG/5ML SUSP. 120 ML MEMPHIS 19.50 EGP -> ? strength differs, ? different route - not oral solid 3. PHENOXYMETHYL PENICILLIN [2 of 2 - GIVE ALL TOGETHER] Adult 500 mg every 6 to 8 hours for 5 to 7 days in combination with metronidazole x 5-7 days Peds 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.) 3kg -> 75-150 mg/day 4kg -> 100-200 mg/day 5kg -> 125-250 mg/day 6kg -> 150-300 mg/day 7kg -> 175-350 mg/day 8kg -> 200-400 mg/day 9kg -> 225-450 mg/day 10kg -> 250-500 mg/day 11kg -> 275-550 mg/day 12kg -> 300-600 mg/day 13kg -> 325-650 mg/day 14kg -> 350-700 mg/day 15kg -> 375-750 mg/day 16kg -> 400-800 mg/day 17kg -> 425-850 mg/day 18kg -> 450-900 mg/day 19kg -> 475-950 mg/day 20kg -> 500-1000 mg/day 21kg -> 525-1050 mg/day 22kg -> 550-1100 mg/day 23kg -> 575-1150 mg/day 24kg -> 600-1200 mg/day 25kg -> 625-1250 mg/day 26kg -> 650-1300 mg/day 27kg -> 675-1350 mg/day 28kg -> 700-1400 mg/day 29kg -> 725-1450 mg/day 30kg -> 750-1500 mg/day 31kg -> 775-1550 mg/day 32kg -> 800-1600 mg/day 33kg -> 825-1650 mg/day 34kg -> 850-1700 mg/day 35kg -> 875-1750 mg/day 36kg -> 900-1800 mg/day 37kg -> 925-1850 mg/day 38kg -> 950-1900 mg/day 39kg -> 975-1950 mg/day 40kg -> 1000-2000 mg/day 41kg -> 1025-2000 mg/day (upper capped) 42kg -> 1050-2000 mg/day (upper capped) 43kg -> 1075-2000 mg/day (upper capped) 44kg -> 1100-2000 mg/day (upper capped) 45kg -> 1125-2000 mg/day (upper capped) 46kg -> 1150-2000 mg/day (upper capped) 47kg -> 1175-2000 mg/day (upper capped) 48kg -> 1200-2000 mg/day (upper capped) 49kg -> 1225-2000 mg/day (upper capped) 50kg -> 1250-2000 mg/day (upper capped) 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. Caution 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. Egypt OSPEN 1.0 MIU 12 F.C.TABS. SANDOZ 24.00 EGP (2.00/unit) -> ? strength differs OSPEN 1.5 MIU 12 F.C.TABS. SANDOZ 41.00 EGP (3.42/unit) -> ? strength differs Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)