Acute Necrotizing Ulcerative Gingitivitis (ANUG), now classified as Necrotizing Periodontal Disease according to the 1999 American Academy of Periodontics classification system, is a distinct and specific disease characterized by rapidly progressive ulceration typically starting at the tip of the interdental papilla, spreading along the gingival margins, and going on to acute destruction of the periodontal tissue.
This disease entity has been described as far back as the days of Hippocrates and is known by many synonyms such as trench mouth, Vincent’s disease, and Vincent’s gingivostomatitis. A rapid progression of the lesion can lead to cancrum oris1,2 which, in turn, is very disfiguring and potentially fatal. With the advent of antibiotics and with improved nutritional status, the incidence has decreased and even become extinct in developed countries. Although, with the increasing incidence of severe immunodeficiency states such as seen in Acquired Immunodeficiency Syndrome (AIDS) the lesion has once more, become a well recognized and often encountered clinical entity in developed countries.3
In developing countries ANUG remains a commonly diagnosed clinical lesion. This
is because of the existing poor nutritional status, stressful living conditions,
poor oral hygiene, and a state of debilitation often resulting from endemic
contagious diseases.1,4-6
This
lesion is important in the light of the severe irreversible disabilities that
results when its progression is unchecked. The highlighted risk factors
are highly controllable, especially where the issue of malnutrition is concerned. In
developing nations where the standard of living is gradually on the decline,
this disfiguring oral lesion becomes very important clinically as more and
more children are exposed to the risk factors which lead to the development
of ANUG.
In recent years, there has been increasing recognition for the need to further study ANUG, particularly in view of its contribution to the incidence of cancrum oris – which has been described as a “neglected third world disease” and a “neglected scourge” of children in Sub-Saharan Africa.1,7 The increasing focus on global health issues has made ANUG a lesion of significant interest for developing countries where malnutrition is high and because of HIV/AIDS, a global pandemic.
This disease entity has been described as far back as the days of Hippocrates and is known by many synonyms such as trench mouth, Vincent’s disease, and Vincent’s gingivostomatitis. A rapid progression of the lesion can lead to cancrum oris1,2 which, in turn, is very disfiguring and potentially fatal. With the advent of antibiotics and with improved nutritional status, the incidence has decreased and even become extinct in developed countries. Although, with the increasing incidence of severe immunodeficiency states such as seen in Acquired Immunodeficiency Syndrome (AIDS) the lesion has once more, become a well recognized and often encountered clinical entity in developed countries.3
