Necrotizing ulcerative gingivitis: a discussion of four dissimilar presentations.

Background: Necrotizing ulcerative gingivitis (NUG) is a periodontal disease characterized by pain, bleeding, and necrosis of interdental papillae. This series details treatment of four cases, followed by a discussion of the disease.

Case Description: Four patients presented to four practitioners for treatment of severe gingival pain, each eventually being diagnosed with NUG. All patients in this series were successfully treated using accepted protocols, and though each was different with regard to presenting signs and symptoms, all responded similarly to treatment. Similar to the patients described in this series, NUG cases in general can present with varying degrees of involvement from barely-noticeable to starkly severe.

Clinical Implications: The most severe cases of NUG are often more destructive in appearance than those most commonly seen in textbooks, while in the mildest cases the appearance can almost be mistaken for health.