Gingivitis can be prevented through regular oral hygiene that includes daily brushing and flossing. Hydrogen peroxide, saline, alcohol or chlorhexidine mouth washes may also be employed. In a 2004 clinical study, the beneficial effect of hydrogen peroxide on gingivitis has been highlighted.

Rigorous plaque control programs along with periodontal scaling and curettage also have proved to be helpful, although according to the American Dental Association, periodontal scaling and root planing are considered as a treatment for periodontal disease, not as a preventive treatment for periodontal disease. In a 1997 review of effectiveness data, the U.S. Food and Drug Administration (FDA) found clear evidence showing that toothpaste containing triclosan was effective in preventing gingivitis.

Daily oral hygiene measures to prevent periodontal disease include:

- Brushing properly on a regular basis (at least twice daily), with the patient attempting to direct the toothbrush bristles underneath the gumline, helps disrupt the bacterial-mycotic growth and formation of subgingival plaque.

- Flossing daily and using interdental brushes (if the space between teeth is large enough), as well as cleaning behind the last tooth, the third molar, in each quarter

- Using an antiseptic mouthwash: Chlorhexidine gluconate-based mouthwash in combination with careful oral hygiene may cure gingivitis, although they cannot reverse any attachment loss due to periodontitis.

- Using periodontal trays to maintain dentist-prescribed medications at the source of the disease: The use of trays allows the medication to stay in place long enough to penetrate the biofilms where the microorganism are found.

- Regular dental check-ups and professional teeth cleaning as required: Dental check-ups serve to monitor the person's oral hygiene methods and levels of attachment around teeth, identify any early signs of periodontitis, and monitor response to treatment.

- Microscopic evaluation of biofilm may serve as a guide to regaining commensal health flora.

Typically, dental hygienists (or dentists) use special instruments to clean (debride) teeth below the gumline and disrupt any plaque growing below the gumline. This is a standard treatment to prevent any further progress of established periodontitis. Studies show that after such a professional cleaning (periodontal debridement), microbial plaque tends to grow back to precleaning levels after about three to four months. Nonetheless, the continued stabilization of a patient's periodontal state depends largely, if not primarily, on the patient's oral hygiene at home, as well as on the go. Without daily oral hygiene, periodontal disease will not be overcome, especially if the patient has a history of extensive periodontal disease.

Periodontal disease and tooth loss are associated with an increased risk, in male patients, of cancer.

Contributing causes may be high alcohol consumption or a diet low in antioxidants.

Treatment options include antibiotic therapy (not a permanent solution), endodontic (root canal) therapy, or extraction.

The focus of treatment is to remove plaque. Therapy is aimed at the reduction of oral bacteria and may take the form of regular periodic visits to a dental professional together with adequate oral hygiene home care. Thus, several of the methods used in the prevention of gingivitis can also be used for the treatment of manifest gingivitis, such as scaling, root planing, curettage, mouth washes containing chlorhexidine or hydrogen peroxide, and flossing. Interdental brushes also help remove any causative agents.

Powered toothbrushes work better than manual toothbrushes in reducing the disease.

The active ingredients that "reduce plaque and demonstrate effective reduction of gingival inflammation over a period of time" are triclosan, chlorhexidine digluconate, and a combination of thymol, menthol, eucalyptol, and methyl salicylate. These ingredients are found in toothpaste and mouthwash. Hydrogen peroxide was long considered a suitable over-the-counter agent to treat gingivitis. There has been evidence to show the positive effect on controlling gingivitis in short-term use. A study indicates the fluoridated hydrogen peroxide-based mouth rinse can remove teeth stain and reduce gingivitis.

Based on a limited evidence, mouthwashes with essential oils may also be useful, as they contain ingredients with anti-inflammtory properties, such as thymol, menthol and eucalyptol.

The bacteria that causes gingivitis can be controlled by using an oral irrigator daily with a mouthwash containing an antibiotic. Either amoxicillin, cephalexin, or minocycline in 16 ounces of a non-alcoholic fluoride mouthwash is an effective mixture.

Overall, intensive oral hygiene care has been shown to improve gingival health in individuals with well-controlled type 2 diabetes. Periodontal destruction is also slowed down due to the extensive oral care. Intensive oral hygiene care (oral health education plus supra-gingival scaling) without any periodontal therapy improves gingival health, and may prevent progression of gingivitis in well-controlled diabetes.

The cornerstone of successful periodontal treatment starts with establishing excellent oral hygiene. This includes twice-daily brushing with daily flossing. Also, the use of an interdental brush is helpful if space between the teeth allows. For smaller spaces, products such as narrow picks with soft rubber bristles provide excellent manual cleaning. Persons with dexterity problems, such as arthritis, may find oral hygiene to be difficult and may require more frequent professional care and/or the use of a powered toothbrush. Persons with periodontitis must realize it is a chronic inflammatory disease and a lifelong regimen of excellent hygiene and professional maintenance care with a dentist/hygienist or periodontist is required to maintain affected teeth.

Chemical antimicrobials may be used by the clinician to help reduce the bacterial load in the diseased pocket.

"Among the locally administered adjunctive antimicrobials, the most positive results occurred for tetracycline, minocycline, metronidazole, and chlorhexidine. Adjunctive local therapy generally reduced PD levels...Whether such improvements, even if statistically significant, are clinically meaningful remains a question."

Minocycline is typically delivered via slim syringe applicators.

Chlorhexidine impregnated chips are also available.

Hydrogen peroxide is a naturally occurring antimicrobial that can be delivered directly to the gingival sulcus or periodontal pocket using a custom formed medical device called a Perio Tray. [Title = Custom Tray Application of Peroxide Gel as an Adjunct to Scaling and Root Planing in the Treatment of Periodontitis:

A Randomized, Controlled Three-Month Clinical Trial J Clin Dent 2012;23:48–56.]

Hydrogen peroxide gel was demonstrated to be effective in controlling the bacteria biofilm [Subgingival Delivery of Oral Debriding Agents: A Proof of Concept J Clin Dent 2011;22:149–158] The research shows that a direct application of hydrogen peroxide gel killed virtually all of the bacterial biofilm, was directly and mathematically delivered up to 9mm into periodontal pockets.

Sub-antimicrobial doses of doxycycline (SDD) have been used to alter host response to the periodontal pathogens. This is believed to disrupt the action of matrix metalloproteinases and thus minimise host mediated tissue destruction.

"The adjunctive use of SDD with SRP is statistically more effective than SRP alone in reducing PD and in achieving CAL gain."

Periapical periodontitis of some form is a very common condition. The prevalence of periapical periodontitis is generally reported to vary according to age group, e.g. 33% in those aged 20–30, 40% in 30- to 40-year-olds, 48% in 40- to 50-year-olds, 57% in 50- to 60-year-olds and 62% in those over the age of 60. Most epidemiologic data has been generated in European countries, especially Scandinavia. Millions of root canal treatments are carried out in the United States each year, although the total number of root canal treatments is an imperfect indicator of the prevalence of periapical periodontitis, since not always is it performed due to the presence of periapacial periodontitis, and not all cases of asymptomatic periodontitis will be treated in this manner, either due to lack of patient attendance or watchful waiting.

Dental plaque is also extremely common in domestic animals such as dogs and cats. However, the bacteria associated with canine and feline plaque appear to be different from that of humans. If untreated it can lead to more severe gum disease such as periodontitis; hence veterinarians often recommend oral healthcare products for affected pets.

Disclosing tablets are similar to that of disclosing gels, except that they are placed in the mouth and chewed on for approximately one minute. The remaining tablet or saliva is then spit out. Disclosing gels will show the presence of the plaque, but will often not show the level of maturity of the plaque. Disclosing tablets are often prescribed or given to patients with orthodontic appliances for use before and after tooth brushing to ensure optimal cleaning. These are also helpful educational tools for young children or patients that are struggling to remove dental plaque in certain areas. Disclosing gels and tablets are useful for individuals of all ages in ensuring efficient dental plaque removal.

Since most toothache is the result of plaque-related diseases, such as tooth decay and periodontal disease, the majority of cases could be prevented by avoidance of a cariogenic diet and maintenance of good oral hygiene. That is, reduction in the number times that refined sugars are consumed per day and brushing the teeth twice a day with fluoride toothpaste and flossing. Regular visits to a dentist also increases the likelihood that problems are detected early and averted before toothache occurs. Dental trauma could also be significantly reduced by routine use of mouthguards in contact sports.

Treatment includes irrigation and debridement of necrotic areas (areas of dead and/or dying gum tissue), oral hygiene instruction and the uses of mouth rinses and pain medication. If there is systemic involvement, then oral antibiotics may be given, such as metronidazole. As these diseases are often associated with systemic medical issues, proper management of the systemic disorders is appropriate.

If there is persistent continuation of inflammation and bleeding, a prescription of antiplaque rinse would be useful.

Aetiology of CTS is multifactorial, the causative factors include:

- previous restorative procedures.

- occlusal factors

- developmental conditions/anatomical considerations.

- trauma

- others, e.g, aging dentition or presence of lingual tongue studs.

Most commonly involved teeth are mandibular molars followed by maxillary premolars, maxillary molars and maxillary premolars. in a recent audit, mandibular first molar thought to be most affected by CTS possibly due to the wedging effect of opposing pointy, protruding maxillary mesio-palatal cusp onto the mandibular molar central fissure.

There is no universally accepted treatment strategy, but, generally, treatments aim to prevent movement of the segments of the involved tooth so they do not move or flex independently during biting and grinding and so the crack is not propagated.

- Stabilization (core buildup) (a composite bonded restoration placed in the tooth or a band is placed around the tooth to minimize flexing)

- Crown restoration (to do the same as above but more permanently and predictably)

- Root Canal therapy (if pain persists after above)

- Extraction

Untreated, the infection may lead to rapid destruction of the periodontium and can spread, as necrotizing stomatitis or noma, into neighbouring tissues in the cheeks, lips or the bones of the jaw. As stated, the condition can occur and be especially dangerous in people with weakened immune systems. This progression to noma is possible in malnourished susceptible individuals, with severe disfigurement possible.

A systematic review reported that there is some evidence that rinsing with chlorhexidine (0.12% or 0.2%) or placing chlorhexidine gel (0.2%) in the sockets of extracted teeth reduces the frequency of dry socket. Another systematic review concluded that there is evidence that prophylactic antibiotics reduce the risk of dry socket (and infection and pain) following third molar extractions of wisdom teeth, however their use is associated with an increase in mild and transient adverse effects. The authors questioned whether treating 12 patients with antibiotics to prevent one infection would do more harm overall than good, in view of the potential side effects and also of antibiotic resistance. Nevertheless, there is evidence that in individuals who are at clear risk may benefit from antibiotics. There is also evidence that antifibrinolytic agents applied to the socket after the extraction may reduce the risk of dry socket.

Some dentists and oral surgeons routinely debride the bony walls of the socket to encourage hemorrhage (bleeding) in the belief that this reduces the incidence of dry socket, but there is no evidence to support this practice. It has been suggested that dental extractions in females taking oral contraceptives be scheduled on days without estrogen supplementation (typically days 23–28 of the menstrual cycle). It has also been suggested that teeth to be extracted be scaled prior to the procedure.

Prevention of alveolar osteitis can be exacted by following post-operative instructions, including:

1. Taking any recommended medications

2. Avoiding intake of hot fluids for one to two days. Hot fluids raise the local blood flow and thus interfere with organization of the clot. Therefore, cold fluids and foods are encouraged, which facilitate clot formation and prevent its disintegration.

3. Avoiding smoking. It reduces the blood supply, leading to tissue ischemia, reduced tissue perfusion and eventually higher incidence of painful socket.

4. Avoiding drinking through a straw or spitting forcefully as this creates a negative pressure within the oral cavity leading to an increased chance of blood clot instability.

There are many causes of toothache and its diagnosis is a specialist topic, meaning that attendance at a dentist is usually required. Since many cases of toothache are inflammatory in nature, over the counter non-steroidal anti-inflammatory drugs (NSAIDs) may help (unless contraindicated, such as with a peptic ulcer). Generally, NSAIDs are as effective as aspirin alone or in combination with codeine. However, simple analgesics may have little effect on some causes of toothache, and the severe pain can drive individuals to exceed the maximum dose. For example, when acetaminophen (paracetamol) is taken for toothache, an accidental overdose is more likely to occur when compared to people who are taking acetaminophen for other reasons. Another risk in persons with toothache is a painful chemical burn of the oral mucosa caused by holding a caustic substance such as aspirin tablets and toothache remedies containing eugenol (such as clove oil) against the gum. Although the logic of placing a tablet against the painful tooth is understandable, an aspirin tablet needs to be swallowed to have any pain-killing effect. Caustic toothache remedies require careful application to the tooth only, without coming into excessive contact with the soft tissues of the mouth.

For the dentist, the goal of treatment generally is to relieve the pain, and wherever possible to preserve or restore function. The treatment depends on the cause of the toothache, and frequently a clinical decision regarding the current state and long-term prognosis of the affected tooth, as well as the individual's wishes and ability to cope with dental treatment, will influence the treatment choice. Often, administration of an intra-oral local anesthetic such as lidocaine and epinephrine is indicated in order to carry out pain-free treatment. Treatment may range from simple advice, removal of dental decay with a dental drill and subsequent placement of a filling, to root canal treatment, tooth extraction, or debridement.

The College of Registered Dental Hygienists of Alberta (CRDHA) defines a dental hygienist as "a health care professional whose work focuses on the oral health of an individual or community." These dental professionals aim to improve oral health by educating patients on the prevention and management of oral disease. Dental hygienists can be found performing oral health services in various settings, including private dental offices, schools, and other community settings, such as long-term care facilities. As mentioned above in the clinical significance section, plaque and calculus deposits are a major etiological factor in the development and progression of oral disease. An important part of the scope of practice of a dental hygienist is the removal of plaque and calculus deposits. This is achieved through the use of specifically designed instruments for debridement of tooth surfaces. Treatment with these types of instruments is necessary as calculus deposits cannot be removed by brushing or flossing alone. To effectively manage disease or maintain oral health, thorough removal of calculus deposits should be completed at frequent intervals. The recommended frequency of dental hygiene treatment can be made by a registered professional, and is dependent on individual patient needs. Factors that are taken into consideration include an individual's overall health status, tobacco use, amount of calculus present, and adherence to a professionally recommended home care routine.

Hand instruments are specially designed tools used by dental professionals to remove plaque and calculus deposits that have formed on the teeth. These tools include scalers, curettes, jaquettes, hoes, files and chisels. Each type of tool is designed to be used in specific areas of the mouth. Some commonly used instruments include sickle scalers which are designed with a pointed tip and are mainly used supragingivally. Curettes are mainly used to remove subgingival calculus, smooth root surfaces and to clean out periodontal pockets. Curettes can be divided into two subgroups: universals and area specific instruments. Universal curettes can be used in multiple areas, while area specific instruments are designed for select tooth surfaces. Gracey curettes are a popular type of area specific curettes. Due to their design, area specific curettes allow for better adaptation to the root surface and can be slightly more effective than universals. Hoes, chisels, and files are less widely used than scalers and curettes. These are beneficial when removing large amounts of calculus or tenacious calculus that cannot be removed with a curette or scaler alone. Chisels and hoes are used to remove bands of calculus, whereas files are used to crush burnished or tenacious calculus.

For hand instrumentation to be effective and efficient, it is important for clinicians to ensure that the instruments being used are sharp. It is also important for the clinician to understand the design of the hand instruments to be able to adapt them properly.

Ultrasonic scalers, also known as power scalers, are effective in removing calculus, stain, and plaque. These scalers are also useful for root planing, curettage, and surgical debridement. Not only is tenacious calculus and stain removed more effectively with ultrasonic scalers than with hand instrumentation alone, it is evident that the most satisfactory clinical results are when ultrasonics are used in adjunct to hand instrumentation. There are two types of ultrasonic scalers; piezoelectric and magnetostrictive. Oscillating material in both of these handpieces cause the tip of the scaler to vibrate at high speeds, between 18,000 and 50,000 Hz. The tip of each scaler uses a different vibration pattern for removal of calculus. The magnetostrictive power scaler vibration is elliptical, activating all sides of the tip, whereas the piezoelectric vibration is linear and is more active on the two sides of the tip.

Special tips for ultrasonic scalers are designed to address different areas of the mouth and varying amounts of calculus buildup. Larger tips are used for heavy subgingival or supragingival calculus deposits, whereas thinner tips are designed more for definitive subgingival debridement. As the high frequency vibrations loosen calculus and plaque, heat is generated at the tip. A water spray is directed towards the end of the tip to cool it as well as irrigate the gingiva during debridement. Only the first 1–2 mm of the tip on the ultrasonic scaler is most effective for removal, and therefore needs to come into direct contact with the calculus to fracture the deposits. Small adaptations are needed in order to keep the tip of the scaler touching the surface of the tooth, while overlapping oblique, horizontal, or vertical strokes are used for adequate calculus removal.

Current research on potentially more effective methods of subgingival calculus removal focuses on the use of near-ultraviolet (NUV) and near-infrared lasers, such as Er,Cr:YSGG lasers. The use of lasers in periodontal therapy offers a unique clinical advantage over conventional hand instrumentation, as the thin and flexible fibers can deliver laser energy into periodontal pockets that are otherwise difficult to access. Near-infrared lasers, such as the Er,CR:YSGG laser, have been proposed as an effective adjunct for calculus removal as the emission wavelength is highly absorbed by water, a large component of calculus deposits. An optimal output power setting of 1.0-W with the near-infrared Er,Cr:YSGG laser has been shown to be effective for root scaling. Near-ultraviolet (NUV) lasers have also shown promise as they allow the dental professional to remove calculus deposits quickly, without removing underlying healthy tooth structure, which often occurs during hand instrumentation. Additionally, NUV lasers are effective at various irradiation angles for calculus removal. Discrepancies in the efficiency of removal are due to the physical and optical properties of the calculus deposits, not to the angle of laser use. Dental hygienists must receive additional theoretical and clinical training on the use of lasers, where legislation permits.

Overall, the incidence of dry socket is about 0.5–5% for routine dental extractions, and about 25–30% for impacted mandibular third molars (wisdom teeth which are buried in the bone).

Females are more frequently affected than males, but this appears to be related to oral contraceptive use rather than any underlying gender predilection. The majority of dry sockets occur in individuals aged between 20 and 40 which is when most dental extractions occur, although for any given individual it is more likely to occur in with increasing age.

Other possible risk factors include periodontal disease, acute necrotizing ulcerative gingivitis, local bone disease, Paget's disease of bone, osteopetrosis, cemento-osseous dysplasia, a history of previously developing a dry socket with past extractions and inadequate oral hygiene. Other factors in the postoperative period that may lead to loss of the blood clot include forceful spitting, sucking through a straw, and coughing or sneezing.

Gingival and periodontal pockets are dental terms indicating the presence of an abnormal depth of the gingival sulcus near the point at which the gingival tissue contacts the tooth.

For those patients with periodontitis as a manifestation of hematologic disorders, coordination with the patient's physician is instrumental in planning periodontal treatment. Therapy should be avoided during periods of exacerbation of the malignancy or during active phases of chemotherapy, and antimicrobial therapy might be considered when urgent treatment must be performed when granulocyte counts are low.

The best method of maintaining the health of teeth is to practice exemplary oral hygiene. More tooth loss is likely to occur if intervention takes place. However, factors such as present complaint, patient age, severity of the problem, can affect the treatment plan or options.

If the destruction continues unabated apically and reaches the junction of the attached gingiva and alveolar mucosa, the pocket would thus be in violation of the mucogingival junction and would be termed a mucogingival defect.

All impacted teeth, unless otherwise contraindicated, are considered for surgical removal. Thus, dental extractions will often take place. The type of extraction (simple or surgical) often depends on the location of the teeth.

In some cases, for aesthetic purposes, a surgeon may wish to expose the canine. This may be achieved through open or closed exposure. Studies show no advantage of one method over another.