Necrotizing periodontal diseases

Necrotizing periodontal diseases
Other namesNPD
A fairly mild presentation of necrotizing gingivitis at the typical site on the gums of the anterior mandibular teeth
SpecialtyPeriodontology
Symptomspain, bad breath, fever, bleeding gums, malaise
ComplicationsProgression
TypesNecrotizing gingivitis, Necrotizing periodontitis, Necrotizing stomatitis
CausesBacterial infection by Prevotella intermedia, Treponema, Selenomonas, Fusobacterium spp, Spirochetes and compromised host immune response
Risk factorsHIV/AIDS, malnutrition, psychological stress, sleep deprivation, inadequate oral hygiene, pre-existing gingivitis, history of necrotizing periodontal disease, tobacco and alcohol use, youth, Caucasian ethnicity, orthodontics
Diagnostic methodBased on clinical findings (necrosis, ulcer of interdental papilla; gingival bleeding, pain, pseudomembrane formation, halitosis)
Differential diagnosisherpetic gingivostomatitis, mucous membrane pemphigoid, pemphigus vulgaris, toothbrush abrasion, clinical attachment loss and alveolar bone loss (in NP, NS)
Preventionoral hygiene
Treatmentdebridement (dental), metronidazole

Necrotizing periodontal diseases is one of the three categories of periodontitis as defined by the American Academy of Periodontology/European Federation of Periodontology 2017 World Workshop classification system.

Necrotizing periodontal diseases are a type of inflammatory periodontal (gum) disease caused by bacteria (notably fusobacteria and spirochaete species). The diseases appear to represent different severities or stages of the same disease process, although this is not completely certain. These diseases usually have a sudden onset. The mildest on the spectrum is necrotizing gingivitis (NG), followed by the successively more severe conditions necrotizing periodontitis (NP), necrotizing stomatitis and finally cancrum oris (noma), which is frequently fatal.