Specific Organisms and Therapeutic Regimens
Necrotizing ulcerative gingivitis is a rare disease, a study by Dufty et al finding, for example, a prevalence of 0.11% in the British armed forces. [1, 2] Organism-specific therapeutic regimens for acute necrotizing ulcerative gingivitis (ANUG) are provided below, including those for Peptostreptococci, Prevotella, Bacteroides, and Aggregatibacter actinomycetemcomitans. [3]
Peptostreptococci, Prevotella species, Bacteroides species
See the list below:
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Amoxicillin 500 mg PO TID for 10d or
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Clindamycin 150-300 mg PO TID for 10d or
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Doxycycline 100 mg PO BID for 10d [4]
Aggregatibacter (formerly Actinobacillus) actinomycetemcomitans
See the list below:
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Amoxicillin 500 mg PO TID for 10d plus metronidazole 250 mg PO TID for 10d or
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Doxycycline 100 mg PO BID for 10d or
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Clindamycin 300 mg PO TID for 10d [5]
Adjunctive therapy
See the list below:
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Saline rinses can help to speed resolution; oral rinses with a hydrogen peroxide 3% solution may be of benefit [6]
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Chlorhexidine 0.12% oral rinse 15 mL BID [7]
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For human immunodeficiency virus (HIV) ̶ positive patients, consider nystatin rinse 5 mL QID or fluconazole 200 mg PO daily for 7-14d
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Patients with ANUG should be given a topical anesthetic and nonsteroidal anti-inflammatory drugs (NSAIDs), because pain control is very important in allowing the patient to perform good oral hygiene [8]
