Necrotizing gingivostomatitis is caused by infection with Vincent's spirochete and fusiform bacteria. Clinically, this condition is relatively rare. When local or systemic resistance declines, oral hygiene is poor, or nutrition is inadequate, the disease can progress rapidly with severe lesions. The acute form is more common in children, while the chronic form is more prevalent in adults. Since the disease has a sudden onset, progresses quickly, and can lead to serious consequences, it is crucial not to delay treatment. Early medical intervention is essential, and maintaining thorough oral care and hygiene during the illness is highly important.

bubble_chart Clinical Manifestations

1. In acute cases, the gums show necrosis and ulcers, the interdental papillae disappear, there is gingival bleeding, obvious tooth loosening, foul oral odor, difficulty in eating and swallowing, increased saliva, swelling and pain in regional lymph nodes, elevated white blood cells accompanied by fever, headache, and general lack of strength.

2. Chronic cases are rare, mainly manifested as easy gingival bleeding, mild pain, fetid mouth odor, and gray-black necrotic tissue visible at the gingival papillae.

bubble_chart Auxiliary Examination

This disease progresses rapidly, with extensive gingival necrosis potentially occurring within a short period. Therefore, early in the course of the illness, samples from the affected area should be collected for smear culture testing to strive for early diagnosis and prompt, effective treatment.

bubble_chart Diagnosis

1. In acute cases, the onset is sudden, with general fatigue and weakness, fever, necrosis of the gingival margin and interdental papillae appearing gray-black, tendency of gingival bleeding, and fetid mouth odor.

3. Localized pain and increased salivation are present.

4. Smears of necrotic tissue reveal abundant spirochetes and fusiform bacilli.

5. In chronic cases, the main manifestations include tendency of gingival bleeding, mild pain, fetid mouth odor, and gray-black necrotic tissue visible on the interdental papillae.

bubble_chart Treatment Measures

1. Systemic supportive therapy.

2. Use effective antibiotics + metronidazole for anti-infection.

3. Remove local necrotic tissue.

4. Strengthen oral care.

5. Chinese medicine treatment based on pattern identification. {|104|}

bubble_chart Prognosis

1. Cure: Symptoms and signs disappear, and lesions heal.

2. Improvement: Symptoms and signs significantly improve, and lesions tend to heal.

3. No recovery: Symptoms and signs show no improvement.