dental disorders
Acute Necrotizing Ulcerative Gingivitis (ANUG)
Treatment of ANUG
Debridement Rinses (eg,hydrogen peroxide,chlorhexidine) Improved oral hygiene Sometimes oral antibiotics Treatment of ANUG consists of gentle debridement with a hand scaler or ultrasonic device. Debridement is done over several days. The patient uses a soft toothbrush or washcloth to wipe the teeth. Rinses at hourly intervals with warm normal saline or twice a day with 1.5%hydrogen peroxideor 0.12%chlorhexidinemay help during the first few days after initial debridement. Essential supportive measures include improving oral hygiene (done gently at first), adequate nutrition, high fluid intake, rest, analgesics as needed, and avoiding irritation (eg, caused by smoking or hot or spicy foods). Marked improvement usually occurs within 24 to 48 hours, after which debridement can be completed. If debridement is delayed (eg, if a dentist or the instruments necessary for debridement are unavailable), oral antibiotics (eg,amoxicillin500 mg every 8 hours,erythromycin250 mg every 6 hours, ortetracycline250 mg every 6 hours) may help to provide relief and can be continued until 72 hours after symptoms resolve. Treatment is described elsewhere. If the gingival contour inverts (ie, if the tips of papillae are lost) during the acute phase, surgery is eventually required to prevent subsequent Periodontitis . 