Necrotizing ulcerative gingivitis (NUG), also known as trench mouth or Vincent infection, is a fusospirochetal infection characterized by the classical triad of pain, bleeding, and punched-out crater-like interdental papilla, with predisposing factors including stress, smoking, HIV, immunosuppression, malnutrition, and poor oral hygiene; diagnosis is primarily clinical with characteristic gray pseudomembrane and fetor oris, and treatment involves gentle debridement, oxidizing mouthwash, chlorhexidine, and metronidazole in severe cases.
Deep Dive
Prerequisite Knowledge
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Deep Dive
Necrotising Ulcerative gingivitis main pointsAdded:
NUG, necrotizing ulcerative gingivitis, trench mouth, Vincent infection. Most common age group, young adults, stress associated patients. Etiology, fusospirochetal infection, spirochetes plus fusobacterium plus prevotella intermedia.
Predisposing factors, stress, smoking, HIV, immunosuppression, malnutrition, poor oral hygiene, sleep deprivation.
Classical triads, pain, bleeding, punched-out interdental papilla.
Pathognomonic feature, punched-out crater-like papilla.
Other features, gray pseudomembranous, fetor oris, foul smell, metallic taste, excess salivation, fever plus lymphadenopathy in severe cases.
Histopathology, four zones described by Listgarten.
Diagnosis, mainly clinical diagnosis. Organisms seen, Borrelia vincentii, fusiform bacilli. Anug involving periodontal attachment plus bone. Necrotizing ulcerative periodontitis, NUP. Severe progression, necrotizing stomatitis into noma. First-line treatment, gentle debridement, oxidizing mouthwash, chlorhexidine mouthwash. Drug of choice in severe cases, metronidazole.
Commonly asked NEET MDS key words, trench mouth, Vincent infection, punched-out papilla, fetor oris, fusospirochetal complex, gray pseudomembrane. Thank you.
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