Best Toothpaste For Gingivitis & Gum Disease 2023

If you have recently visited a dental professional, they may have told you that you have gum disease or gingivitis. You may now be wondering if there is actually a toothpaste that is best for your gums.

In this post I explain the various options available to you, and what you should do when brushing your teeth.

The list of toothpastes below is specifically targeted at people with gum disease – including both gingivitis or periodontal disease. I also explain the different ways in which toothpastes can help your gum disease.

If you are unsure about whether or not you have gum disease, get yourself booked in with a dental professional for a check up.

Do you need a specialist toothpaste for gum disease, or can you use a regular one? 

If you have gum disease, the most important thing is how you clean your teeth. The physical action of cleaning to remove the bacteria is more important than what toothpaste you use.

Using a regular toothpaste, and with good brushing and interdental cleaning technique, you should be able to get on top of early gum disease.

That said, you may want to use a specific toothpaste for gum disease if:

• You want help seeing where the plaque is – you could try a toothpaste with disclosing in it.
• You want additional help from specific antibacterial chemicals.
• Your gums are so sore that regular toothpaste hurts – you may want a more gentle toothpaste.

The toothpaste acts as a chemical plaque control in addition to the mechanical plaque control. In fact, having the right toothpaste can actually improve your gum disease as it has been shown:

• Toothpastes with antimicrobials improve gum disease more than just mechanical cleaning alone (as explained by Teles & Teles).
• Toothpaste spread onto the soft tissues in the mouth, which are not normally physically cleaned (and therefore bacteria can linger here). The chemicals can reduce the bacteria load on areas like the tongue and cheeks which would not otherwise be cleaned.

How to clean your teeth if you have gum disease

Signs of gingivitis (early gum disease) include bleeding gums, and you may have noticed this before you even went to see a dental professional. Gingivitis is caused by bacteria not cleaned away thoroughly. 

Left untreated, early gum disease will progress into periodontal disease, where bone is lost around the teeth and they may start to become loose.

The single most important thing you can do to reverse early gum disease, and to slow down progression of periodontal disease, is thorough cleaning. That includes:

• Brushing at least twice daily, for two minutes, using an electric toothbrush.
• Using interdental cleaning aids daily – interdental brushes, floss, and water flosses are all options available.
• Supplementary mouthwashes with active ingredients to minimise bacteria in the mouth.
• Professional cleaning to help remove calculus (tartar) to make cleaning easier at home.

A good cleaning technique, on a daily basis, wil help lessen the amount of gum disease causing bacteria in the mouth. And most of this benefit comes from the physical action of brushing and/or flossing etc.

Are there toothpastes that strengthen gums? 

The short answer is yes! There are definitely some toothpastes that will help your gums.

It is worth noting that the key to getting rid of gum disease, especially in the early stages, is good cleaning techniques at home.

And the main role of toothpaste is prevention of cavities due to the fluoride in it. 

But some toothpastes contain specific ingredients to help with gum disease. 

Ingredients added to toothpaste can help managing gum disease in the following ways:

• Disclosing agents that dye plaque. This makes plaque easier to see and therefore easier to remove. Traditionally this is done using separate disclosing tablets, but now this can also be found in some toothpastes. As managing plaque to reduce bacteria is one of the key aspects of managing disease, it can be helpful to have this included in a toothpaste. 
• Antibacterial agents that help to kill bacteria, preventing plaque formation and thus reducing the total number of bacteria in the mouth. This includes
  • chlorhexidine. 
  • triclosan. 
  • peptides. 
  • Sodium bicarbonate.
  • Use of herbal ingredients including essential oils (although evidence mostly looks at these in mouthwash form)
• Regeneration of the gums and decreasing swelling. Hyaluronic acid is a newer ingredient, beneficial because of its anti-inflammatory effects. This means that it can reduce the swelling in the gums caused by your body’s reaction to the gum-disease causing bacteria. HA is also antibacterial in itself, helping to reduce the number of bacteria in the gums.
• Prevention of calculus (tartar) formation.
  • Zinc

Gentle toothpastes for sore gums 

If you have sore gums, you may find that some toothpastes cause a burning sensation, or even ulcers. If that is the case, you may want to try an unflavoured or SLS free toothpaste. 

You may also want a toothpaste for receding gums, which may be sore. Receding gums can also cause tooth sensitivity, so you may be interested in combining a toothpaste for gingivitis and sensitivity, or having a look at our best sensitivity toothpastes.

If you can clean thoroughly with your toothbrush, interdental cleaners, and one of these toothpastes, you should notice a difference in any bleeding or soreness in as little as a week!

Recommendations for a gentle toothpaste include:

• AloeSense (view on Amazon) – not specifically formulated for gums, but this does contain Aloe vera and Allantoin which will help soothe sore gums. It also has the ADA Seal of Acceptance due to the fluoride content.
• Gengigel (view on Amazon) – for a healing paste that will not cause irritation and will even actively help sore gums to get better. Although this is not a toothpaste, it can be used where there are sore areas to help healing.

About the ingredients found in toothpastes for gingivitis

In the sections below I have included some information about the ingredients that are sometimes included with toothpastes for gum disease.

Chlorhexidine

Chlorhexidine is an antimicrobial, meaning that it kills bacteria and fungi in the mouth. The benefit of chlorhexidine is that it is able to stick to the mouth surface and so have a prolonged effect.

Its ability to prevent plaque formation after toothbrushing is magnified when it is combined with fluoride, which can be found in toothpastes.

Lacalut Aktiv toothpaste, available on Amazon, is the only toothpaste currently available (at the time of writing) on Amazon.com to contain this active ingredient.

Herbal ingredients

There are many studies into the use of herbal ingredients, which have been used for centuries in some cultures. That said, the scientific evidence is limited as to whether these are more effective than other ingredients that could be added. 

It does appear that the inclusion of natural herbal ingredients is more effective in managing gum disease than a toothpaste that contains no specific ingredient (e.g. chlorhexidine, triclosan, stannous fluoride etc). In particular, herbal toothpastes seem to help in reducing plaque in the first few weeks of use, after which the effect is not as great.

Hyaluronic acid

Hyaluronic acid, or hyaluronan as it is also called, occurs naturally in the body, and is found in many different tissues. You may have seen it in many different cosmetics and pharmaceuticals, from lip fillers to treatment of osteoarthritis. 

Evidence has shown hyaluronic acid to be anti-inflammatory, anti-oedematous, and anti-bacterial. Experiments on HA toothpastes show reduction in bleeding gums. In fact, analysis of the data confirms “0.2% Hyaluronan containing gel has a beneficial effect in the treatment of plaque induced gingivitis”. 

Peptides

Peptides can include two different types of ingredients:

• enzymes and proteins normally found in saliva, and which naturally reduce the amount of bacteria in the mouth. Adding peptides to toothpaste causes a reaction which ultimately kills bacteria found in saliva and plaque.
• Peptides which help stimulate the body’s natural regeneration mechanisms to aid “regrowth” of the gums.

Examples of enzymes found in toothpastes include: amyloglucosidase, glucose oxidase and lactoperoxidase.

Examples of proteins found in the toothpastes include: lysozyme, lactoferrin and colostrum.

Sodium Bicarbonate

Sodium bicarbonate, or baking soda, can be added to toothpaste and has been shown to have antimicrobial effects at high doses.

Stannous Fluoride

Stannous fluoride has an anticavity effect because of the fluoride element. But, unlike other forms of fluoride in toothpaste, it can also have a significant positive effect on the gums. Studies have shown that the stannous fluoride:

• Kills bacteria in plaque. Therefore prevents build up of plaque and irritation and bleeding gums caused by plaque.
• Is anti-inflammatory, reducing irritation to gums from plaque.

Triclosan/copolymer

Addition of triclosan to a fluoride toothpaste causes reduction in plaque and gum disease. Unfortunately, due to potential safety concerns, there are currently no toothpastes with triclosan available on the Canadian market.

Zinc complexes

Zinc is able to prevent plaque hardening into calculus. By preventing calculus build up, gums are easier to clean. Overall this means less bacteria buildup and therefore the gums are less likely to be affected by bacteria induced gingivitis. 

On top of this, zinc itself is antibacterial so can also kill the bacteria leading to gum disease.

Zinc can be found in toothpastes as:

• Zinc + arginine  – e.g. Colgate Total SF.
• Zinc gluconate – e.g. TheraBreath PerioTherapy.
• Zinc PCA – e.g. BioRepair toothpastes.

FAQ

Is it possible to use a whitening toothpaste if you have gingivitis / which one is best?

Yes, it is possible to use a whitening toothpaste if you have gum disease.

Whitening toothpastes remove stains from the teeth, and are often more abrasive than a regular toothpaste. It doesn’t actually whiten the overall colour of the teeth.

But I should point out that this additional abrasiveness may cause further irritation to gums which are already sore and so you may want to avoid them.

Is there a difference between gingivitis and periodontitis?

Gingivitis is early gum disease and affects only the gums. You would notice it as swollen and/or bleeding gums. Periodontitis is more advanced gum disease with loss of bone around the tooth and often there is also receding gums.

What sort of toothpastes should I use with early gum disease (mild gingivitis)?

A basic toothpaste containing stannous fluoride, sodium bicarbonate, or herbal ingredients can help alleviate the swelling and bleeding associated with early gum disease. The most important thing is how you clean though, so make sure you have the best techniques by following this advice.

What sort of toothpastes should I use with advanced gum disease (periodontitis)?

More advanced gum disease, which isn’t improving despite good cleaning efforts, may require extra ingredients to help the gums heal. You may want to try a toothpaste containing hyaluronic acid or peptides to help the gums heal.

What is the best toothpaste for receding gums?

Receding gums can lead to soreness in the gums and sensitivity from the tooth. 

If the gums are sore when brushing try a gentle toothpaste (like those listed above), or perhaps try a non-mint toothpaste or SLS free toothpaste. Mouthwashes may also help if your gums are too sore to brush.

If you are suffering from tooth sensitivity because of receding gums, try a specific sensitivity toothpaste.

What is the best toothpaste for bleeding gums?

Bleeding gums are a sign of gum disease. The best toothpaste would be one designed for gingivitis, containing stannous fluoride, sodium bicarbonate or herbal ingredients.

Does stannous fluoride cause staining?

In some formulations, stannous fluoride can cause staining. In the correct formulation the staining effect is much less, if at all.