Treatment of Severe Acute Necrotizing Ulcerative Gingivitis with Fever and Lymphadenopathy

Clinical Scenario

This protocol addresses severe acute necrotizing ulcerative gingivitis that has progressed to systemic involvement, marked by fever and regional lymphadenopathy. This presentation is clinically distinct from mild or uncomplicated ANUG and requires a more comprehensive management approach.

Condition Features

Severe cases with fever and lymphadenopathy represent a sub-population where local periodontal disease is accompanied by systemic signs. This systemic involvement influences the treatment strategy beyond what would be used for uncomplicated presentations.

Treatment Approach (Partial Overview)

Management combines mechanical debridement of the gingiva with systemic antibiotic therapy. The complete protocol specifies the instrumentation method, antibiotic selection, and the full regimen — including any alternative agents.

Treatment Goals

• Body temperature returns to normal within 24 hours, with the patient becoming relatively asymptomatic
• Gingival appearance consistent with health at two weeks