Last reviewed: 4 Jul 2021
Last updated: 17 Jun 2021

Summary

Definition

History and exam

Key diagnostic 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 necrotizing gingivitis)
  • stress (in necrotizing gingivitis)
  • severe (viral) infections (in necrotizing gingivitis)
  • previous history of necrotizing gingivitis
  • stress (in plaque-induced gingivitis)
  • xerostomic medications
  • male sex
  • extreme living conditions (necrotizing gingivitis)
  • high alcohol intake
  • substance abuse

Diagnostic investigations

Treatment algorithm

Contributors

Authors

Giuseppina Campisi, DDS, MS

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.

Giuseppe Pizzo, DDS

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.

Acknowledgements

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.

Disclosures

BLP and AEC declare that they have no competing interests.

Peer reviewers

Gary Armitage, MD

Professor

Division of Periodontology

University of California

San Francisco

CA

Disclosures

GA declares that he has no competing interests.

Lynn Solomon, MD

Assistant Professor

Tufts University

Boston

MA

Disclosures

LS declares that she has no competing interests.

Donald J. DeNucci, DDS, MS

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.

Stephen Porter, BSc, PhD, MD, FDSRCS, FDSRCSEd, FHEA

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.

Marco Carrozzo, MD, DSM

Professor of Oral Medicine

School of Dental Sciences

University of Newcastle Upon Tyne

UK

Disclosures

None declared

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