Background: Gingivitis has been typically characterized by its clinical appearance (ulcerative, hemorrhagic, necrotizing, purulent), etiology, its causation (drug-induced, hormonal, nutritional, infectious, plaque-induced), and how long it lasts (acute, chronic). The most frequent kind of gingivitis is a constant form caused by plaque, says a cosmetic dentist.

Acute necrotizing ulcerative gingivitis, also know to many as trench mouth, is an acute infectious gingivitis. The term ‘trench mouth’ came from WWI, when it was a common disease among trench-bound soldiers.

Gingivitis is an inflammatory process limited to the mucosal epithelial tissue surrounding the cervical portion of the teeth and the alveolar processes.

Pathophysiology:

These pockets deepen and may bleed during tooth brushing, flossing, and even normal chewing. As this persistent inflammation continues, periodontal ligaments break down and destruction of the local alveolar bone occurs. Teeth loosen and eventually fall out.

The most common type of gingivitis involves the marginal gingiva and is brought on by the accumulation of microbial plaques in persons with inadequate oral hygiene says a cosmetic dentist. Gingivitis proceeds through an initial stage to produce early lesions, which then progress to advanced disease.

Noma (cancrum oris) is a syndrome in which ANUG spreads beyond the gingiva. The infection invades local tissues of the mouth and face says a redmond dentist

The initial stage of an acute exudative inflammatory response begins within 4 or 5 days of plaque accumulation. Both gingival fluid and transmigration of neutrophils increase. Deposition of fibrin and destruction of collagen can be noted in the initial stage.

At approximately 1 week, transition to early lesions is marked by the change to predominately lymphocytic infiltrates. Monocytes and plasma cells also may be present. With time, lesions become chronic and are characterized by the presence of plasma cells and B lymphocytes. As chronic local inflammation progresses, pockets develop where the gingiva separates from the tooth.

ANUG is a completely different syndrome caused by acute infection of the gingiva with organisms such as Prevotella intermedia, alpha-hemolytic streptococci, Actinomyces species, or any of a number of different oral spirochetes. ANUG may result in accelerated destruction of affected tissues, as well as local or systemic spread of infection.

Kirkland Dentist