Acute necrotizing ulcerative gingivitis: Difference between revisions
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==Background== | ==Background== | ||
#Severe gingival disease | #Severe gingival disease that may spread to local soft tissue and bone | ||
#Must distinguish from herpes gingivostomatitis | #Must distinguish from herpes gingivostomatitis | ||
##Herpes has more systemic signs, less bleeding, lack of interdental papilla involvement | ##Herpes has more systemic signs, less bleeding, lack of interdental papilla involvement | ||
#Associated with immunosuppression, especially HIV | #Associated with immunosuppression, especially HIV | ||
##Other associations include poor oral hygeine/nutrition/sleep, stress, ETOH/tobacco use, age<21, Caucasians, malaria/measles/parasites | |||
==Clinical Features== | ==Clinical Features== | ||
Revision as of 15:55, 12 May 2014
Background
- Severe gingival disease that may spread to local soft tissue and bone
- Must distinguish from herpes gingivostomatitis
- Herpes has more systemic signs, less bleeding, lack of interdental papilla involvement
- Associated with immunosuppression, especially HIV
- Other associations include poor oral hygeine/nutrition/sleep, stress, ETOH/tobacco use, age<21, Caucasians, malaria/measles/parasites
Clinical Features
- Triad of:
- Pain
- Ulcerated or "punched out" interdental papillae
- Gingival bleeding
- Secondary signs:
- Fetid breath
- "Wooden teeth" feeling
- Teeth mobility
- Fever
- Malaise
Differential Diagnosis
Dentoalveolar Injuries
Odontogenic Infections
- Acute alveolar osteitis (dry socket)
- Acute necrotizing ulcerative gingivitis (trench mouth)
- Dental abscess
- Periapical abscess
- Periodontal abscess
- Ludwig's angina
- Pulpitis (dental caries)
- Pericoronitis
- Peritonsillar abscess (PTA)
- Retropharyngeal abscess
- Vincent's angina - tonsillitis and pharyngitis
Other
Treatment
- Chlorhexidine 0.01% oral rinse BID
- Metronidazole 500mg PO TID
- Dental debridement and scaling
See Also
Source
- ER Atlas
- Tintinalli
- UpToDate