Wednesday, November 12, 2014

Regarding acute necrotizing ulcerative gingivitis (ANUG):

Regarding acute necrotizing ulcerative gingivitis (ANUG):
a. Herpes virus is the most commonly implicated pathogen.
b. Metallic taste and foul breath are common presenting complaints.
c. Systemic symptoms, such as fever and malaise, are uncommon.
d. Systemic antibiotics are generally not helpful.
e. Dental follow-up is recommended on an as-needed basis.

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The answer is b. Acute necrotizing ulcerative gingivitis (ANUG or “trench mouth”) is a periodontal infection caused by fusobacteria and spirochetes. Patients present complaining of gingival pain, a metallic taste, and foul breath. Systemic symptoms such as fever, malaise, and regional lymphadenopathy are common.

On examination,
the gingiva is swollen and fiery red. The interdental papillae are ulcerated or “punched out” and covered with a grayish pseudomembrane. Treatment includes warm saline irrigation, antibiotics (PCN, erythromycin, or tetracycline), systemic analgesics, and local topical anesthetics. Antibiotics often provide dramatic relief within 24 hours. Dental follow-up is required because ANUG can be complicated by the destruction of underlying alveolar bone.

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