necrotizing ulcerative gingivitis

(redirected from Vincent infection)

gingivitis

 [jin″jĭ-vi´tis]
inflammation of the gums. Bleeding is a primary symptom, and other symptoms include swelling, redness, pain, and difficulty in chewing. Gingivitis can lead to the more serious disorder known as periodontitis. There are numerous causes, of which the primary one is pathogenic microorganisms in the crevices between the gums and the teeth. Other contributing factors are general poor health, host response to inflammation, hormonal imbalances, malnutrition, reactions to certain medications, irregular teeth, badly fitting fillings or dentures that irritate the gums, systemic disease, and infections such as herpetic gingivostomatitis. Gingivitis is best prevented by correct brushing and flossing of the teeth and proper oral hygiene. A good diet containing the necessary minerals and vitamins is also important. Vitamin deficiencies and anemia and other blood dyscrasias are often accompanied by gingivitis.
acute necrotizing ulcerative gingivitis (ANUG) (acute ulcerative gingivitis) necrotizing ulcerative gingivitis.
Dilantin gingivitis generalized hyperplasia of the gingiva, which may also rarely involve other areas of the oral mucosa, resulting in overgrowth of the fibrous tissue from the interaction of plaque accumulation with the anticonvulsive agent Dilantin (phenytoin).
necrotizing ulcerative gingivitis (NUG) an inflammatory destructive disease of the gingivae that has a sudden onset with periods of remission and exacerbation. It is marked by ulcers of the gingival papillae that become covered by sloughed tissue and circumscribed by linear erythema. Fetid breath, increased salivation, and spontaneous gingival hemorrhage are additional features. It may extend to other parts of the oral mucosa, with lesions involving the palate or pharynx (see also vincent's angina). The etiology is uncertain, but many authorities believe it is caused by a bacterial complex in the presence of predisposing factors such as preexisting gingival disease, smoking, severe stress, radical changes in eating or sleeping patterns, or nutritional deficiency. It has also been associated with immunodeficiency conditions such as infection with the human immunodeficiency virus (HIV). Although the disease often occurs in an epidemic pattern, it has not been shown to be contagious. Called also acute necrotizing ulcerative or acute ulcerative gingivitis.
pregnancy gingivitis any of various gingival changes ranging from gingivitis to the so-called pregnancy tumor.
Vincent's gingivitis necrotizing ulcerative gingivitis.

nec·ro·tiz·ing ul·cer·a·tive gin·gi·vi·tis (NUG),

an acute or recurrent gingivitis of young and middle-aged adults characterized clinically by gingival erythema and pain, fetid odor, necrosis, and sloughing of interdental papillae and marginal gingiva that gives rise to a gray pseudomembrane; fever, regional lymphadenopathy, and other systemic manifestations also may be present. A fusiform bacillus and Treponema vincentii can be isolated from the gingival tissues in large numbers and are thought to play a significant but poorly defined role in the pathogenesis.

acute necrotising ulcerative gingivitis

A condition characterised by progressive necrosis of intraoral tissues and upper respiratory abscesses, which is seen in those with poor oral hygiene and suboptimal nutrition, often linked to herpes simplex and anaerobic flora—e.g., Fusobacterium spp, spirochetes.

Acute necrotizing ulcerative gingivitis (ANUG) appears to be the most appropriate for a polymicrobial (‘fusospirochetal’) gingival infection that most commonly occurs in a back-group of malnutrition, stress and poor oral hygiene; with time the ulcerating or ulceromembranous lesions may spread to the rest of the oral cavity.

It is also a more accurate term for the antiquated Vincent's angina, in which the infection is seated on the soft palate and tonsils.

The microbiological analysis of the lesions of ANUG, given that certain bacteria may cause acute (eg Streptococcus spp) and/or ulceromembranous (eg Corynebacterium diphtheriae) lesions.

“Trench mouth” is a coinage of World War I vintage which attributed ANUG to living in close quarters—i.e., “the trenches”.

Clinical findings
Pain, oedema, punched-out ulcers, pseudomembrane formation, halitosis.

DiffDx
Erythema multiforme, lichen planus, pemphigus, bullous pemphigoid.
 
Management
H2O2, antibiotics (e.g., tetracycline, if fever or lymphadenopathy), saline mouth rinse, local anaesthetics.

nec·ro·tiz·ing ul·cer·a·tive gin·gi·vi·tis

(NUG) (nek'rō-tīz-ing ŭl'sĕr-ă-tiv jin'ji-vī'tis)
An acute or recurrent gingivitis of young and middle-aged adults characterized clinically by gingival erythema and pain, fetid odor, and necrosis and sloughing of interdental papillae and marginal gingiva that give rise to a gray pseudomembrane; fever, regional lymphadenopathy, and other systemic manifestations also may be present. A fusiform bacillus and Treponema vincentii can be isolated from the gingival tissues in large numbers and are considered to play a significant but poorly defined role in the pathogenesis.
Synonym(s): fusospirochetal gingivitis, trench mouth, ulceromembranous gingivitis, Vincent disease, Vincent infection.

Vincent,

Henri, French physician, 1862-1950.
Vincent angina - an ulcerative infection of the oral soft tissues, including the tonsils and pharynx, caused by fusiform and spirochetal organisms.
Vincent bacillus
Vincent disease - Synonym(s): necrotizing ulcerative gingivitis
Vincent spirillum - the spirillum or spirochete found in association with Vincent bacillus.
Vincent tonsillitis - angina limited chiefly to the tonsils, caused by Vincent organisms (bacillus and spirillum).
Vincent white mycetoma - mycetoma caused by Actinomadura madurae and occurring in North Africa, India, Argentina, and Cuba.