Local Factors

•  Poor oral hygiene

•  Predominance of spirochetes, fusiforms and P. intermedia, and occasionally Selenomonas and Porphyromonas in the plaque

•  Smoking (local irritation by tar products) 5 6

NUG/P patients usually exhibit similar life styles and habits: The teeth do not occupy a high position in the patient’s consciousness. They are usually young adults, heavy smokers (tobacco: high content of tar and nicotine), exercise poor oral hygiene, and become interested in treatment only during acute, painful exacerbations.

The clinical course is acute, but fever occurs only seldom. Within only a few days, interdental papillae may be lost to ulceration. The acute phase may gravitate into a chronic interval stage if host resistance improves (see pre-disposing factors) or through self-treatment (rinsing with a disinfectant mouthwash). Untreated ulcerative gingivitis exhibits a high recurrence rate, and may develop rapidly into ulcerative periodontitis (attachment loss with shallow pockets!).

Therapy: In addition to local debridement, the early stages of treatment should be supported with medicaments. Topical application of ointments containing cortisone or antibiotics, or metronidazol may be effective. In severe cases, systemic metronidazol (e. g., Flagyl) may be prescribed (see Medicaments, p. 287). After reduction of the acute symptoms in advanced cases, surgery to correct gingival contours may be indicated.

  • Contact
  • Category: Dental disease