Last reviewed:September 2019
Last updated:August  2019

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • bleeding on tooth brushing
  • dental plaque
  • necrosis and ulcers in free gingiva

Other diagnostic factors

  • halitosis
  • redness, swelling, and puffy gingiva
  • pseudomembrane formation
  • cervical lymphadenopathy
  • fever
  • malaise
  • pain

Risk factors

  • poor oral hygiene
  • tobacco
  • diabetes mellitus
  • pregnancy
  • severe malnutrition or marginal nutritional deficiencies
  • HIV/AIDS (in necrotising gingivitis [NG])
  • stress (in necrotising gingivitis [NG])
  • severe (viral) infections (in necrotising gingivitis)
  • previous history of necrotising gingivitis
  • stress (in plaque-induced gingivitis)
  • xerostomic medicines
  • male sex
  • extreme living conditions (necrotising gingivitis)
  • high alcohol intake
  • substance abuse

Diagnostic investigations

Treatment algorithm

Contributors

Professor of Oral Diseases

Department of Surgical, Oncological and Oral Sciences

School of Dentistry

University of Palermo

Palermo

Italy

Disclosures

GC declares that she has no competing interests.

Associate Professor of Periodontology and Dental Public Health

Department of Surgical, Oncological and Oral Sciences

School of Dentistry

University of Palermo

Palermo

Italy

Disclosures

GP declares that he has no competing interests.

Dr Giuseppina Campisi and Dr Giuseppe Pizzo would like to gratefully acknowledge Dr Bruce L. Pihlstrom and Dr Alice E. Curran, previous contributors to this topic. BLP and AEC declare that they have no competing interests.

Peer reviewersVIEW ALL

Professor

Division of Periodontology

University of California

San Francisco

CA

Disclosures

GA declares that he has no competing interests.

Assistant Professor

Tufts University

Boston

MA

Disclosures

LS declares that she has no competing interests.

Program Director

Practice Based Research Networks

National Institute of Dental and Craniofacial Research

NIH

Bethesda

MD

Disclosures

DJD declares that he has no competing interests.

Institute Director

Professor of Oral Medicine

Academic Head, Oral Medicine and Special Needs Dentistry Unit

Honorary Consultant in Oral Medicine, UCLH NHS Foundation Trust

UCL Eastman Dental Institute

London

UK

Disclosures

SP declares that he has no competing interests.

Professor of Oral Medicine

School of Dental Sciences

University of Newcastle Upon Tyne

UK

Disclosures

None declared

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