Necrotizing Gingivitis and Periodontitis
- Necrotizing gingivitis is a common, non-contagious infection of the gums characterised by painful, bleeding, sloughing ulceration and loss of the interdental papillae.
- Predisposing factors for necrotizing gingivitis include psychological stress, sleep deprivation, poor oral hygiene, smoking, immunosuppression, and malnutrition.
- Treatment for necrotizing gingivitis involves debridement and antibiotics.
- Necrotizing periodontitis is an extension of necrotizing gingivitis and involves infection that leads to attachment loss.
- It affects the gingiva, periodontal ligament, and alveolar ligament.
- Progression beyond the mucogingival junction indicates an advanced stage.

Necrotizing Stomatitis
- Necrotizing stomatitis is the progression of necrotizing periodontitis beyond the mucogingival junction.
- Atypical cases may develop without prior necrotizing periodontal disease lesions.
- It is characterised by tissue involvement beyond the gingiva.
- Prompt treatment is required to prevent further complications, as it can cause significant damage to oral tissues.

Noma
- Noma is a necrotizing and destructive infection of the mouth and face.
- It primarily affects malnourished children in developing countries.
- Noma is a disfiguring and often fatal condition.
- There is a possible connection to pre-existing necrotizing gingivitis, but it has not been confirmed.
- The majority of cases of necrotizing gingivitis and periodontitis do not progress to noma.

Vincent's Angina
- Vincent's angina is not a necrotizing periodontal disease but is often confused with necrotizing gingivitis.
- It is characterised by tonsillitis and pharyngitis, not involving the gums.
- It is named after Jean Hyacinthe Vincent, a French physician.
- Vincent's angina is caused by a fusospirochetal infection of the pharynx and palatine tonsils.
- It was previously known as Vincent's gingivitis.

General Information
- Necrotizing periodontal diseases encompass necrotizing gingivitis, necrotizing periodontitis, necrotizing stomatitis, noma, and Vincent's angina.
- Necrotizing gingivitis and periodontitis are common infections of the gums, while necrotizing stomatitis involves tissue involvement beyond the gingiva.
- Noma is a severe infection primarily affecting malnourished children in developing countries.
- Vincent's angina is a condition involving tonsillitis and pharyngitis, not related to the gums.

Necrotizing periodontal diseases (Wikipedia)

Necrotizing periodontal diseases is one of the three categories of periodontitis as defined by the American Academy of Periodontology/European Federation of Periodontology 2017 World Workshop classification system.

Necrotizing periodontal diseases
Other names	NPD
A fairly mild presentation of necrotizing gingivitis at the typical site on the gums of the anterior mandibular teeth
Specialty	Periodontology
Symptoms	pain, bad breath, fever, bleeding gums, malaise
Complications	Progression
Types	Necrotizing gingivitis, Necrotizing periodontitis, Necrotizing stomatitis
Causes	Bacterial infection by Prevotella intermedia, Treponema, Selenomonas, Fusobacterium spp, Spirochetes and compromised host immune response
Risk factors	HIV/AIDS, malnutrition, psychological stress, sleep deprivation, inadequate oral hygiene, pre-existing gingivitis, history of necrotizing periodontal disease, tobacco and alcohol use, youth, Caucasian ethinicity, orthodontics
Diagnostic method	Based on clinical findings (necrosis, ulcer of interdental papilla; gingival bleeding, pain, pseudomembrane formation, halitosis)
Differential diagnosis	herpetic gingivostomatitis, mucous membrane pemphigoid, pemphigus vulgaris, toothbrush abrasion, clinical attachment loss and alveolar bone loss (in NP, NS)
Prevention	oral hygiene
Treatment	debridement (dental), metronidazole

Necrotizing periodontal diseases are a type of inflammatory periodontal (gum) disease caused by bacteria (notably fusobacteria and spirochaete species). The diseases appear to represent different severities or stages of the same disease process, although this is not completely certain. These diseases are usually have a sudden onset with sudden onset. The mildest on the spectrum is necrotizing gingivitis (NG), followed by the successively more severe conditions necrotizing periodontitis (NP), necrotizing stomatitis and finally cancrum oris (noma), which is frequently fatal.