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Measuring  Gingivitis and the role of zinc-based toothpaste in management of gingivitis

In a 13 week study it was found that there was a reduction in GI with a zinc based toothpaste like Pepsodent Gumcare+. Consult the article to learn more.

pepsodent pack shot

Gingivitis: The common form of periodontal disease

Gingivitis is a condition that affects the gingiva and is characterised by gingival redness and oedema and the absence of periodontal attachment loss. It is caused due to the accumulation of bacteria at the gingival margin. Gingivitis is prevalent at all ages and is considered the most common form of periodontal disease.

It is usually painless, rarely leads to spontaneous bleeding, and is often characterised by subtle clinical changes, resulting in most patients being unaware of the condition or unable to recognise it.1,2 Effective prevention of periodontal diseases can be achieved by the mechanical removal of dental plaque using a toothbrush and dental floss.3

Prevalence of Gingivitis

In India, nearly ~97% of the patients experience a form of periodontal diseases. Patients usually come with a minor form of gingivitis which then develops into periodontitis  if not taken care of in its early stages

Gingival Index (GI): The diagnostic tool for gum diseases

Understaning GI score

The gingival index is used for assessing the severity of Gingivitis and its location by examining the qualitative changes of gingival tissue. To obtain the gingival index score, labial and lingual surfaces of the gingival margins and the interdental papilla of all erupted teeth except 3rd molars are examined.6






Mild inflammation, a slight change in colour, little change in the texture of any portion of the gingival unit


Mild inflammation of entire gingival unit


Moderate inflammation of gingival unit


Severe inflammation of gingival unit

Application and Interpretation of GI Score 6

Gingival scores


0.1 to 1.0

Mild gingivitis

1.1 to 2.0

Moderate gingivitis

2.1 to 3.0

Severe Gingivitis

They fall under the following category based on their present state: 2

  • Controlled: Healthy/stable
  • Remission: Gingival inflammation
  • Uncontrolled: Recurrent periodontitis/unstable

Management of Gingivitis

Role of zinc in the management of Gingivitis

Zinc is an effective plaque inhibitor7 with proven activity against bacteria associated with periodontal disease.8

Clinical study

A 13-week double-blind, randomized, parallel design in vivo study assessed gingival inflammatibleeding in 158 patients using zinc-based toothpaste  containing a 2 % zinc Citrate trihydrate and  fluoride and a control group using toothpaste containing fluoride twice daily for 13 weeks. Patients were assessed using the gingival index (GI) at baseline, weeks 1, 2, and 13. Gingival inflammation was assessed visually and scored between 0 and 3.10


  • The group using the   Zinc-based toothpaste showed a significant improvement in GI at 7 days (measuring gingivitis & bleeding) compared to a toothpaste containing fluoride. 10
  • The participants using Zinc-based toothpaste continued to show significant improvement in gum bleeding and inflammation over 13 weeks. 10
improvements infographics

Significant improvement in gingival index at 7 days

improvements infographics

Improvement with zinc-based toothpaste continues to 13 weeks


This study demonstrates that the toothpaste containing zinc citrate trihydrate and fluoride e was significantly more effective than a control fluoride toothpaste in improving gingival condition after 1 week of product use and  continued to show significant improvement in gum bleeding and inflammation over a period of 13 weeks. 10

97 % of the participants in the group using toothpaste with Znc citrate trihydrate showed a significant improvement in Gingival health

Tips for counselling patients with Gingivitis

It is important for patient with Gingivitis to adhere to following advises:

  • Good oral hygiene, including brushing the teeth adequately at least twice a day (morning and last thing at night), with a clinically proven toothpaste  for  preventing  gingivitis such as Pepsodent  Gumcare  Plus  with zinc citrate, Flossing three times a week or using interdental brushes regularly
  • Stopping smoking if necessary.
  • Use of a zinc-based toothpaste to control gingivitis symptoms



  1. Trombelli L, et al. Plaque-induced gingivitis: Case definition and diagnostic considerations. Journal of Clinical Periodontology. 2018;45:S44-S67.
  2. Chapple I, et al. peridontal health and gingivitis: A guideline for clinicians [Internet]. 2020 [cited 2 June 2020]. Available from:
  3. Yaghini J, et al. Gingival Inflammatory Indices and Dental Stain Index after Using Aloe Vera-Green Tea Mouthwash, Matrica Mouthwash, or 0.2% Chlorhexidine Mouthwash Compared with Placebo in Patients with Gingival Inflammation. 2020.
  4. Murakami S, et al. Dental plaque-induced gingival conditions. Journal of Clinical Periodontology. 2018;45:S17-S27.
  5. Shewale A, et al. Prevalence of Periodontal Disease in the General Population of India-A Systematic Review. Journal of clinical and diagnostic research. 2016;.
  6. Löe H, et al. The Gingival Index, the Plaque Index and the Retention Index Systems. Journal of Periodontology. 1967;38(6):610-616.
  7. Brading MG, et al. The oral environment: the challenge for antimicrobials in oral care products. International Dental Journal 2003; 53(6):353–362.
  8. Sheng J, et al. Multi-target antimicrobial actions of zinc against oral anaerobes. Archives of Oral Biology 2005; 50:747–757.
  9. Cummins D, et al. Zinc citrate/Triclosan: a new anti-plaque system for the control of plaque and the prevention of Gingivitis: short-term clinical and mode of action studies. Journal of Clinical Periodontology. 1991;18(6):455-461.
  10. Unilever data on file.

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