Acute necrotizing ulcerative gingivitis (ANUG) occurs most frequently in smokers and debilitated patients who are under stress. Other risk factors are poor oral hygiene, nutritional deficiencies, immunodeficiency (eg, HIV/AIDS, use of immunosuppressive drugs), and sleep deprivation. Some patients also have oral candidiasis.
Symptoms and Signs
The usually abrupt onset may be accompanied by malaise or fever. The chief manifestations are
1- Acutely painful, bleeding gingivae
2- Excessive salivation
3- Sometimes overwhelmingly foul breath (fetor oris)
Treatment
1- Debridement
2- Rinses (eg, hydrogen peroxide, chlorhexidine)
3- Improved oral hygiene
4- Sometimes oral antibiotics
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