Lecture Notes: Necrotizing Periodontal Diseases

Overview

• Necrotizing periodontal diseases include three main types:
  1. Necrotizing Gingivitis (NG)
  2. Necrotizing Periodontitis
  3. Necrotizing Stomatitis
• Common feature: Tissue death (necrosis).
• Symptoms include pain, bleeding, inflammation, and necrosis of gum tissues.

Key Terminology

• Necrotizing: Derived from "necrosis," meaning tissue death.
• Pseudomembrane: A gray-white membrane that can be wiped off, typical in necrotizing conditions.
• Trench Mouth/Vincent Infection/NUG: Historical terms for necrotizing periodontal diseases.

Detailed Examination of Each Type

1. Necrotizing Gingivitis (NG)

• Characteristics:
  • Gingival tissue death without bone loss.
  • No gum recession.
  • Symptoms: Pain, severe bleeding, inflammation.

2. Necrotizing Periodontitis

• Characteristics:
  • Necrosis extends to gums, periodontal ligament, and bone.
  • Papilla appears punched out or cratered.
  • Notable pain, possible fever, and swollen lymph nodes.
  • Presence of pseudomembrane.

3. Necrotizing Stomatitis

• Characteristics:
  • Most severe form with significant tissue and bone necrosis.
  • May involve additional structures like tongue, cheek, and palate.
  • Rare and severe, causing substantial tissue loss.

Causes and Risk Factors

• Poor immune response.
• Stress (e.g., emotional stress in soldiers or students).
• Smoking and alcohol usage.
• Poor nutrition or eating habits.
• Higher prevalence in young adults aged 22-24, often Caucasian.

Clinical Indicators

• Pain is the primary symptom, unlike other periodontal diseases.
• Spontaneous bleeding and significant tissue recession.
• Swollen lymph nodes (e.g., submandibular and cervical).
• Possible fever and fatigue.

Management and Recommendations

• Refer to a periodontist.
• Dietary recommendations: Ensure or Boost for nutritional support.
• Educate on smoking cessation to reduce risk.

Historical Context

• Known as "trench mouth" during World War I.
• Common among soldiers due to severe stress and trauma.

Visual Indicators

• Images often show cratered papilla and tissue necrosis.
• Necrotic tissue appears gray and unhealthy, with a strong odor.