Necrotising periodontitis

K05.2

• Description
• General measures
• Medicine treatment
• Referral

DESCRIPTION

An acute, very painful infection of the gingival margin. It is characterised by:

• foul smelling breath
• necrosis and sloughing of the gum margin, especially of the interdental papillae
• loss of gingiva and supporting bone around teeth

May be associated with underlying disease, e.g. HIV.
May lead to disease of surrounding lips and cheeks if not adequately treated.

GENERAL MEASURES

• Relieve pain.
• Improve oral hygiene.
• Exclude underlying disease e.g. HIV.

MEDICINE TREATMENT

Children

• Metronidazole, oral, 7.5 mg/kg/dose 8 hourly for 5 days. See paediatric dosing tool.

Adults

• Metronidazole, oral, 400 mg, 8 hourly for 5 days.

Brush, floss, rinse mouth with water and then rinse with:

• Chlorhexidine 0.2%, 15 mL as mouthwash, twice daily, for 5 days.
  • Do not swallow.
  • Note: Do not eat or drink immediately after this.

Pain:

Children

• Paracetamol, oral, 10–15 mg/kg/dose 6 hourly when required. See paediatric dosing tool.

Adults

• Paracetamol, oral, 1 g 4–6 hourly when required.
  • Maximum dose: 15 mg/kg/dose
  • Maximum dose: 4 g in 24 hours.

REFERRAL

All cases for dental treatment.