Acute necrotizing ulcerative gingivitis in children with cancer

We reviewed the findings for 15 immunosuppressed children with cancer who had 18 episodes of acute necrotizing ulcerative gingivitis. Predisposing factors were then assessed for their influence on the course of infection. The nutritional status and oral hygiene of most patients were poor. Eleven of the 18 episodes involved the spontaneous exfoliation of primary or permanent teeth, and 16 of the 18 episodes were complicated by other infections. The infection completely cleared in only two of ten patients who were not in remission and persisted for more than 15 weeks or until death in all of the remaining patients with active disease. By contrast, all six episodes of infection during remission cleared within an average of 4 1/2 weeks. Among the many contributing factors, decreased host resistance, relapse, and neutropenia seemed to have the most negative influence on recovery from this severe form of gingivitis.