THE CLINIC FEATURES OF

NECROTIC PERIODONTIST
ABDULAZIZ MANSOUR ALHARBI

PB4– 391108720
 Necrotising periodontal disease is the term used to explain a group of infections involving the
mouth in which ulceration with necrosis is the common feature.
There are three forms:
1.Necrotising (ulcerative) gingivitis – involves only the gums.
2.Necrotising (ulcerative) periodontitis – involves loss of the specialised tissue that surrounds and attaches
the teeth.
3.Necrotising stomatitis – in which more extensive mucosal and bone loss occurs beyond the gums and
tissue surrounding and supporting the teeth. Stomatitis means a sore mouth.
 Clinical features of necrotising periodontal disease
1. Necrotising gingivitis

Pain – is constant, ranging from mild to moderate in severity, worse with pressure
such as when chewing.
• Bleeding – can occur spontaneously or with cleaning of the teeth or chewing.
Less commonly, the following may be noted:
• Low grade fever.
• Halitosis (bad breath).
 2. Necrotising periodontitis

Infection affects the specialised attachment tissues surrounding one or more teeth and the resulting
inflammation is more destructive and deeper than in necrotising gingivitis.
Bone is exposed and sometimes destroyed with possible loss of the involved tooth.
Loss of tooth attachment and bone can be rapid.

The signs and symptoms associated with Necrotizing Ulcerative Periodontitis may
include:

•Severe and deep pain.

•Frequent spontaneous bleeding.
•Gum tissue death at more than one location.
•It causes severe damage to the tissues supporting teeth.
•Presence of loose and shaky teeth.

•The infection is deep and bone loss with bone exposure may be seen.

•In NUP, the loss of attachment and bone loss occurs in a span of a few months.

•Swollen lymph node and fever (low-grade) is mostly seen.

•Gums have receded such that teeth appear bigger (or longer); abnormal teeth with
gaps in between them.

•Increased tooth sensitivity, since the roots may be exposed.

•Pus buildup between the teeth and gum.
•Abnormal taste in the mouth.
•Bad breath.
3. Necrotising stomatitis
The infection and inflammation spreads along the surface to involve the oral mucosa beyond the gums. It can
also invade deeply, affecting many teeth.

Because the surface mucosa is lost, the underlying bone can be exposed with subsequent bone loss. This can
result in mouth deformity and be life-threatening if untreated.
References

1-Todescan S, Nizar R. Managing patients with necrotizing ulcerative periodontitis. J Can Dent Assoc.
2013;79:d44. [PubMed]

2-Berres F, Marinello CP. [Necrotizing ulcerative periodontitis. Diagnosis, treatment and follow-up--a
case report]. Schweiz Monatsschr Zahnmed. 2004;114(5):479-95. [PubMed]

3-Novak MJ. Necrotizing ulcerative periodontitis. Ann Periodontol. 1999 Dec;4(1):74-8. [PubMed]

4-Malek R, Gharibi A, Khlil N, Kissa J. Necrotizing Ulcerative Gingivitis. Contemp Clin Dent. 2017 Jul-
Sep;8(3):496-500. [PMC free article] [PubMed]
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