Afternoon People,
This is an interesting non-restorative case – a 10 year old boy who presented with extreme tenderness and ulcerative necrosis of his attached gingiva from 21-24 (#9-12). This was sporadic in appearance but persisted for slightly longer than 2 weeks without resolution this time, which prompted the attendance. Differential diagnoses could include pemphigus, pemphigoid, erosive lichen planus, primary herpetic gingivostomatitis, ANUG – I thought it could be the latter, so treated this like a Gram-negative anaerobic infection: normally if cultured, NUG would include Prevotella intermedia, Treponema pallidum and spirochetes.
Rx: 1) Amoxicillin (500mg) q8h x 7 days, 2) Metronidazole (200mg) q8h x 7 days.
He presented after 5 days of antibiotic use, with this result. The area is still red, but definitely on the mend. Cervitec gel has been used twice a day on the area, and he continues to improve.
Best,
Clarrie
#OralMedicine #NUG #ANUG #OralUlcerations
