Necrotising periodontal diseases

Necrotising periodontal diseases (NPDs) are a group of infectious diseases that include necrotising gingivitis (NG), necrotising periodontitis (NP) and necrotising stomatitis (NS). These three clinical presentations may represent different stages of a continuum of the same disease process, with shared aetiological factors, and broadly similar initial clinical features and treatments. The term ‘ulcerative’ is no longer used in classification as ulceration is considered secondary to the gingival necrosis present. NP may result in destruction of periodontal ligament and supporting bone, while in NS, destruction progresses to deeper tissues such as the lip, cheeks and tongue. These presentations are more frequently seen in patients with HIV/AIDS or other systemic/immune compromise and, in developing countries, among those with severe malnourishment, respectively. In an Irish context, NG will represent the most common clinical form seen in general dental practice and may present as an acute condition requiring urgent management. Consequently, the current review will focus on NG. Table 1 provides an overview of the key aspects of NG.