Saturday, 29 December 2012

ANUG(Acute Necrotizing Ulcerative Gingivitis)

An inflammatory, destructive disease of gingiva.

Clinical Features

  • Sudden onset.

Intraoral Signs And Symptoms

  • Lesions are characterized by punched out, crater like depressions at the crest of the interdental papilla, subsequently involving marginal gingiva and rarely attached gingiva.
  • Craters are covered by grayish pseudomembranous slough..
  • Other signs include gingival hemorrhage or pronounced bleeding on the slightest stimulation.
  • Fetide odour and increased salivation.

Oral Symptoms

  • The lesions are extremely sensitive to touch.
  • Complains of a constant radiating, gnawing pain that is intensified by eating spicy or hot foods and chewing.
  • There is metallic foul taste.
  • Predisposing Factor :  Malnutrition stress and lack of sleep. The causative organisms are spirochetes, furiform bacteria.


  • Includes local debridment ( ultrasonic scaling ), subgingival curettage and use of mild oxygenating solutions.
  • Antibiotic therepy includes penicillins or erythromycin and metronidazole.
  • NSAIDs may be used for pain relief.