[Acute necrotizing gingivitis]

In the western countries, the acute necrotizing gingivitis occurs mainly in early adulthood. It is characterized by a marginal necrosis of the gingiva. The papillae appear to be punched out. The gingiva is painful and bleeds, and the patient often presents halitosis. This fusospirochetal infection invades the epithelium and the underlying connective tissue in its most superficial layer. With early acute necrotizing gingivitis, the use of chlorhexidine 0.2% is recommended, but a thorough scaling is still necessary. Antibiotics are used when the disease becomes more severe. Gingivoplasty may be required at the end of the treatment but a meticulous oral hygiene is the only way to prevent any recurrence of the disease.