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Acute necrotizing ulcerative gingivitis is a painful infection of the gums. Symptoms are acute pain, bleeding, and foul breath. Diagnosis is based on clinical findings. Treatment is gentle debridement, improved oral hygiene, mouth rinses, supportive care, and, if debridement must be delayed, antibiotics. Acute necrotizing ulcerative gingivitis ANUG occurs most frequently in smokers and debilitated patients who are under stress.
Some patients also have oral candidiasis. Ulcerations, which are pathognomonic, are present on the dental papillae and marginal gingiva. These ulcerations have a characteristically punched-out appearance and are covered by a gray pseudomembrane.
Similar lesions on the buccal mucosa and tonsils are rare. Swallowing and talking may be painful. Regional lymphadenopathy often is present. Often, ANUG can manifest without a significant odor, and it also may manifest as a localized condition. Rarely, tonsillar or pharyngeal tissues are affected, and diphtheria or infection due to agranulocytosis must be ruled out by throat culture and complete blood count when the gum manifestations do not respond quickly to conventional therapy.
Treatment of ANUG consists of gentle debridement with a hand scaler or ultrasonic device. Debridement is done over several days. The patient uses a soft toothbrush or washcloth to wipe the teeth.
Rinses at hourly intervals with warm normal saline or twice a day with 1. Essential supportive measures include improving oral hygiene done gently at first , adequate nutrition, high fluid intake, rest, analgesics as needed, and avoiding irritation eg, caused by smoking or hot or spicy foods.
Marked improvement usually occurs within 24 to 48 hours, after which debridement can be completed. If debridement is delayed eg, if a dentist or the instruments necessary for debridement are unavailable , oral antibiotics eg, amoxicillin mg every 8 hours, erythromycin mg every 6 hours, or tetracycline mg every 6 hours may help to provide relief and can be continued until 72 hours after symptoms resolve.
Treatment of oral candidiasis is described elsewhere. If the gingival contour inverts ie, if the tips of papillae are lost during the acute phase, surgery is eventually required to prevent subsequent periodontitis. From developing new therapies that treat and prevent disease to helping people in need, we are committed to improving health and well-being around the world.
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The usually abrupt onset may be accompanied by malaise or fever. The chief manifestations are. Acutely painful, bleeding gingivae. Clinical evaluation. Drug Name Select Trade erythromycin.
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Acute necrotizing ulcerative gingivitis
Acute necrotizing ulcerative gingivitis is a painful infection of the gums. Symptoms are acute pain, bleeding, and foul breath. Diagnosis is based on clinical findings. Treatment is gentle debridement, improved oral hygiene, mouth rinses, supportive care, and, if debridement must be delayed, antibiotics.
Acute Necrotizing Ulcerative Gingivitis (ANUG)
Acute necrotizing ulcerative gingivitis ANUG is a common, non-contagious infection of the gums with sudden onset. The main features are painful, bleeding gums, and ulceration of inter-dental papillae the sections of gum between adjacent teeth. This disease, along with necrotizing ulcerative periodontitis NP or NUP is classified as a necrotizing periodontal disease , one of the seven general types of gum disease caused by inflammation of the gums periodontitis. The often severe gum pain that characterizes ANUG distinguishes it from the more common chronic periodontitis which is rarely painful.