| Necrotizing ulcerative gingivitis/periodontitis | |
|---|---|
| Classification and external resources | |
| ICD-10 | A69.1 |
| ICD-9 | 101 |
| DiseasesDB | 13866 |
| MeSH | D005892 |
Acute necrotizing ulcerative gingivitis (ANUG) or necrotizing ulcerative gingivitis (NUG) is a sub-classification of necrotizing periodontal disease, an infection of the gum tissue.[1] This presents as an acute infection of the gingiva without involvement of the other tissues of the periodontium. If the infection has progressed deeper into the periodontal tissues, it is subclassified as "necrotizing ulcerative periodontitis" (NUP).[2][3]
The condition is also commonly referred to as "trench mouth" and "Vincent's angina", named after French physician Henri Vincent (1862–1950). Other synonyms include "acute membranous gingivitis", "fusospirillary gingivitis", " fusospirillosis", "fusospirochetal gingivitis", "necrotizing gingivitis", "phagedenic gingivitis", "ulcerative gingivitis", "Vincent stomatitis", "Vincent gingivitis", and "Vincent infection".[4]
Contents |
Necrotizing periodontal disease is caused by a bacterial infection that includes anaerobes such as P. intermedia[3] and Fusobacterium as well as spirochetes, such as Borrelia and Treponema.
In the late 1980s-early 1990s, it was originally thought that necrotizing periodontal diseases were strictly a sequela of HIV, and it was even called HIV-associated periodontitis.[5] It is now understood that its association with HIV/AIDS was due to the immunocompromised status of such patients, and it occurs with higher prevalence in association with other diseases in which the immune system is compromised.[2]
Clinical features of necrotizing periodontal disease may include:[2]
Coincident factors may include heavy smoking and poor nutrition,[2] especially for those presenting with necrotizing ulcerative periodontitis.[3]
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. As these diseases are often associated with systemic medical issues, proper management of the systemic disorders is appropriate.[2]
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.
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