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Necrotizing gingivitis

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Many other historical names for this condition (and Vincent's angina) have occurred, including: "acute membranous gingivitis", "fusospirillary gingivitis", " fusospirillosis", "fusospirochetal gingivitis", "phagedenic gingivitis", "Vincent stomatitis", "Vincent gingivitis", and "Vincent infection".
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evolved because the disease was observed in front line soldiers during World War I, thought to be a result at least partly because of extreme psychologic stress they were exposed to. The same condition was appearing in civilians during periods of bombing raids, who were away from the front line, and
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Predisposing factors include smoking, viral respiratory infections and immune defects, such as in HIV/AIDS. Uncommon, except in lower socioeconomic classes, this typically affects adolescents and young adults, especially in institutions, armed forces, etc., or people with HIV/AIDS. The disease has
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In developed countries, this disease occurs mostly in young adults. In developing countries, NUG may occur in children of low socioeconomic status, usually occurring with malnutrition (especially inadequate protein intake) and shortly after the onset of viral infections (e.g.
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Necrotizing periodontitis (NP) is where the infection leads to attachment loss, and involves only the gingiva, periodontal ligament and alveolar ligament. Progression of the disease into tissue beyond the mucogingival junction characterizes necrotizing stomatitis.
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The 1999 American Academy of Periodontology Classification termed the condition "necrotizing ulcerative periodontitis". The "ulcerative" descriptor was removed from the name, because ulceration is considered to be secondary to the necrosis.
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who had relatively good diets during wartime due to rationing, so it is assumed that psychologic stress was the significant causative factor. It has also been associated with high tobacco use in the army.
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and can spread, as necrotizing stomatitis or noma, into neighbouring tissues in the cheeks, lips or the bones of the jaw. As stated, the condition can occur and be especially dangerous in people with
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observes sore mouth and foul smelling breath in Greek soldiers in the 4th century BC. Hunter describes the clinical features of necrotizing gingivitis in 1778, differentiating it from
3381: 1187: 1771: 526:. It is the most minor form of this spectrum, with more advanced stages being termed necrotizing periodontitis, necrotizing stomatitis, and the most extreme, cancrum oris. 3563: 1387: 1352: 498:
The following zones of infection have been described (superficial to deep): the bacterial zone, the neutrophil rich zone, the necrotic zone and the spirochetal zone.
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In the early stages some affected people may complain of a feeling of tightness around the teeth. Three signs/symptoms must be present to diagnose this condition:
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that occurs on a background of impaired local or systemic host defenses. The predisposing factors for necrotizing gingivitis are smoking, psychological stress,
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In the late 1980s-early 1990s, it was originally thought that some necrotizing periodontal diseases seen in severely affected AIDS patients were strictly a
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which is rarely painful. If NG is improperly treated or neglected, it may become chronic and/or recurrent. The causative organisms are mostly
1596: 1226: 899: 3878: 3721: 1556: 1551: 313:) is a common, non-contagious infection of the gums with sudden onset. The main features are painful, bleeding gums, and ulceration of 2995: 2479: 4122: 2755: 1500: 842: 792: 558:. As these diseases are often associated with systemic medical issues, proper management of the systemic disorders is appropriate. 4097: 4034: 4029: 3911: 3339: 3319: 2231: 1197: 523: 318: 3943: 3580: 3034: 1367: 1337: 192: 4220: 3928: 3763: 3768: 1202: 3292: 2901: 2605: 2590: 2528: 2474: 2397: 2215: 2179: 1854: 1055: 3820: 3783: 3513: 2794: 2706: 1040: 924:
NYS Department of Health AIDS Institute. "Clinical Manifestations and Management of HIV-Related Periodontal Disease".
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A fairly mild presentation of necrotizing gingivitis at the typical site on the gums of the anterior mandibular teeth.
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as many soldiers developed the disease, probably because of the poor conditions and extreme psychological stress.
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Predisposing factors include poor oral hygiene, smoking, poor nutrition, psychological stress, and
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The often severe gum pain that characterizes NG distinguishes it from the more common
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This article is about the physiologic disorder. For the similarly named band, see
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Oral and maxillofacial medicine : the basis of diagnosis and treatment
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Necrotizing gingivitis may also be associated with diseases in which the
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tissue. The papillary necrosis of NG has been described as "punched out".
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Oral Health Care for People with HIV Infection: HIV Clinical Guidelines
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Diagnosis is usually clinical. Smear for fusospirochaetal bacteria and
419: 196: 3793: 3265: 2853: 2448: 962: 837:(2nd ed.). Edinburgh: Churchill Livingstone. pp. 101, 347. 604: 713:
Herrera, D., Retamal-Valdes, B., Alonso, B., Feres, M. (June 2018).
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is compromised, including HIV/AIDS. Necrotizing gingivitis is an
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Lindhe, Jan; Lang, Niklaus P.; Karring, Thorkild, eds. (2008).
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Necrotizing gingivitis is part of a spectrum of disease termed
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occurred in epidemic-like patterns, but it is not contagious.
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Untreated, the infection may lead to rapid destruction of the
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Profuse gum bleeding that requires little or no provocation.
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of necrotic areas (areas of dead and/or dying gum tissue),
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Other signs and symptoms may be present, but not always.
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Necrotizing gingivitis has been observed for centuries.
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Necrotizing periodontal diseases are caused by a mixed
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Non-contagious, painful bacterial infection of the gums
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Periodontitis as a manifestation of systemic disease
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Dentistry involving supporting structures of teeth (
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Archived from 615:, a French physician working at the Paris 62: 39: 875: 730: 430:are rare (unlike the typical features of 4196:Oral manifestations of systemic disease 3345:Acute necrotizing ulcerative gingivitis 1208:Combined periodontic-endodontic lesions 692: 3382:As a manifestation of systemic disease 1597:Subepithelial connective tissue graft 7: 3228:Gums and tooth-supporting structures 1183:Generalized aggressive periodontitis 321:, one of the three general types of 3879:Papillary cystadenoma lymphomatosum 3722:Temporomandibular joint dysfunction 4226:Conditions of the mucous membranes 2996:Maxillary lateral incisor agenesis 2480:Inflammatory papillary hyperplasia 1178:Localized aggressive periodontitis 858:Taylor, FE; McKinstry, WH (1917). 538:Treatment includes irrigation and 25: 1501:Full mouth ultrasonic debridement 4098:Cutaneous sinus of dental origin 4035:Obesity hypoventilation syndrome 4030:Central hypoventilation syndrome 3912:Carcinoma ex pleomorphic adenoma 3340:Necrotizing periodontal diseases 3320:Hereditary gingival fibromatosis 2232:Oral and maxillofacial pathology 1198:Necrotizing periodontal diseases 524:necrotizing periodontal diseases 3944:Chronic sclerosing sialadenitis 3581:Osteoporotic bone marrow defect 3035:Keratocystic odontogenic tumour 428:cervical lymph node enlargement 319:necrotizing periodontal disease 193:necrotizing periodontal disease 3929:Sclerosing polycystic adenosis 3764:Benign lymphoepithelial lesion 900:"Definition of Vincent angina" 1: 4123:Melkersson–Rosenthal syndrome 4072:Soft tissues around the mouth 3769:Ectopic salivary gland tissue 1203:Abscesses of the periodontium 3293:Gingival cyst of the newborn 2902:Failure of eruption of teeth 2606:Hand, foot and mouth disease 2591:Focal epithelial hyperplasia 2529:Angina bullosa haemorrhagica 2475:Palatal cysts of the newborn 2398:Transient lingual papillitis 2180:Streptobacillus moniliformis 546:instruction and the uses of 224:Based on clinical findings ( 3821:Salivary gland diverticulum 3784:Necrotizing sialometaplasia 2795:Smokeless tobacco keratosis 2707:Basaloid squamous carcinoma 1939:Louse borne relapsing fever 415:Bad taste (metallic taste). 4252: 3831:Salivary gland hyperplasia 3779:HIV salivary gland disease 3288:Gingival cyst of the adult 2734:Oral florid papillomatosis 1963:Tick borne relapsing fever 1557:Guided tissue regeneration 357:removal of dead gum tissue 267:mucous membrane pemphigoid 263:herpetic gingivostomatitis 29: 4176: 4165: 4078: 4070:Orofacial soft tissues – 4064: 4005: 3988: 3836:Salivary gland hypoplasia 3759: 3746: 3650: 3625: 3564:Bisphosphonate-associated 3458:Idiopathic osteosclerosis 3433: 3411: 3234: 3201: 2929:Dentinogenesis imperfecta 2865: 2839: 2519: 2502: 2455: 2442: 2393:Median rhomboid glossitis 2343: 2330: 2251: 2238: 2171:Fusobacterium polymorphum 2152:Fusobacterium necrophorum 2118:Capnocytophaga canimorsus 1527:Coronally positioned flap 833:Scully, Crispian (2008). 719:Journal of Periodontology 495:, and immunosuppression. 393:Interdental papillae are 70: 61: 4143:Orofacial granulomatosis 3922:Mucoepidermoid carcinoma 3907:Adenoid cystic carcinoma 3841:Salivary gland neoplasms 3632:Temporomandibular joints 3603:Periapical periodontitis 3335:Linear gingival erythema 3103:Regional odontodysplasia 2949:Enamel hypocalcification 2125:Porphyromonas gingivalis 2074:Lymphogranuloma venereum 1582:Pocket reduction surgery 1562:Enamel matrix derivative 1552:Guided bone regeneration 1517:Apically positioned flap 1491:Scaling and root planing 1397:Treatment and prevention 1358:Linear gingival erythema 1313:Clinical attachment loss 1227:A. actinomycetemcomitans 514:or herpetic stomatitis. 353:a weakened immune system 4040:Obstructive sleep apnea 3806:Salivary duct stricture 3586:Paget's disease of bone 3083:Pulp canal obliteration 2924:Dentin hypersensitivity 2870:Amelogenesis imperfecta 2722:Squamous cell carcinoma 2702:Adenosquamous carcinoma 2689:Squamous cell papilloma 2666:Melanocytic oral lesion 2164:Fusobacterium nucleatum 1635:Important personalities 1496:Full mouth disinfection 1459:Host modulatory therapy 1424:Chlorhexidine gluconate 1404:Periodontal examination 870:(Laryngol Sect): 43–8. 572:weakened immune systems 489:opportunistic infection 4186:Hemifacial hypertrophy 4153:Pyostomatitis vegetans 3826:Salivary gland fistula 3816:Salivary gland atresia 3811:Salivary gland aplasia 3665:Mandibular dislocation 3636:muscles of mastication 3514:Calcifying odontogenic 3143:Vertical root fracture 3138:Cracked tooth syndrome 3113:Shovel-shaped incisors 3008:Wisdom tooth impaction 2890:Early childhood caries 2756:Benign mucous membrane 2717:Spindle cell carcinoma 2626:Intraoral dental sinus 2544:Burning mouth syndrome 1998:Leptospira interrogans 1353:Horizontal bony defect 613:Jean Hyacinthe Vincent 307:Necrotizing gingivitis 258:Differential diagnosis 43:Necrotizing gingivitis 4221:Periodontal disorders 3995:Stomatognathic system 3897:Acinic cell carcinoma 3519:Glandular odontogenic 2671:Molluscum contagiosum 2132:Prevotella intermedia 2063:Chlamydia trachomatis 1577:Open flap debridement 1572:Lateral pedicle graft 1173:Chronic periodontitis 1133:Mucogingival junction 1128:Junctional epithelium 609:chronic periodontitis 607:(avitaminosis C) and 334:chronic periodontitis 151:and compromised host 133:Prevotella intermedia 4138:Oral Crohn's disease 4093:Basal cell carcinoma 3732:Condylar hyperplasia 3717:Maxillary hypoplasia 3283:Gingival enlargement 3216:periodontal ligament 2822:Verruciform xanthoma 2554:Condyloma acuminatum 2111:Tannerella forsythia 2104:Bacteroides fragilis 2054:Chlamydia pneumoniae 1934:Borrelia recurrentis 1902:Borrelia burgdorferi 1707:Paul Roscoe Stillman 1682:Willoughby D. Miller 1652:Per-Ingvar BrĂĄnemark 1479:Conventional therapy 1388:Vertical bony defect 1333:Gingival enlargement 1283:Entamoeba gingivalis 1138:Periodontal ligament 1108:Free gingival margin 732:10.1002/JPER.16-0642 315:interdental papillae 295:debridement (dental) 177:psychological stress 4148:Perioral dermatitis 3884:Pleomorphic adenoma 3864:Monomorphic adenoma 3854:Canalicular adenoma 3727:Condylar hypoplasia 3660:Condylar resorption 3504:Lateral periodontal 3463:Mandibular fracture 3362:Periodontal abscess 2959:Turner's hypoplasia 2727:Verrucous carcinoma 2676:Morsicatio buccarum 2656:Lupus erythematosus 2569:Erythema multiforme 2485:Stomatitis nicotina 2157:Lemierre's syndrome 1880:Treponema denticola 1722:James Leon Williams 1587:Socket preservation 1537:Free gingival graft 1419:Bleeding on probing 1373:Periodontal disease 1143:Sulcular epithelium 452:bacterial infection 432:herpetic stomatitis 275:toothbrush abrasion 234:interdental papilla 129:bacterial infection 4191:Facial hemiatrophy 4045:Periodic breathing 3976:Sjögren's syndrome 3849:Basal cell adenoma 3613:Torus mandibularis 3591:Periapical abscess 3574:Osteoradionecrosis 3499:Buccal bifurcation 3478:Intraosseous cysts 3367:Periodontal trauma 3271:Pyogenic granuloma 3118:Supernumerary root 3071:Pulp calcification 3059:Premature eruption 3030:Odontogenic tumors 2827:White sponge nevus 2800:Submucous fibrosis 2744:Smoker's melanosis 2631:Irritation fibroma 2470:High-arched palate 2378:Foliate papillitis 2368:Cunnilingus tongue 2353:Black hairy tongue 2283:Congenital lip pit 2042:Chlamydia psittaci 1868:Treponema carateum 1845:Treponema pallidum 1795:Bacterial diseases 1368:Periodontal pocket 1343:Gingival recession 1234:Capnocytophaga sp. 1015:External resources 379:Signs and symptoms 338:anaerobic bacteria 271:pemphigus vulgaris 4208: 4207: 4204: 4203: 4161: 4160: 4060: 4059: 3984: 3983: 3889:Sebaceous adenoma 3742: 3741: 3621: 3620: 3532:Median mandibular 3527:Nasopalatine duct 3443:Alveolar osteitis 3407: 3406: 3394:Perio-endo lesion 3276:Congenital epulis 3197: 3196: 2954:Enamel hypoplasia 2835: 2834: 2810:Riga–Fede disease 2661:Melanocytic nevus 2601:Hairy leukoplakia 2564:Epulis fissuratum 2498: 2497: 2438: 2437: 2388:Geographic tongue 2326: 2325: 2198: 2197: 2089: 2088: 2016: 2015: 2012: 2011: 1972: 1971: 1761: 1760: 1736:Other specialties 1692:John Mankey Riggs 1677:Preston D. Miller 1642:Tomas Albrektsson 1630: 1629: 1567:Implant placement 1542:Gingival grafting 1532:Crown lengthening 1467: 1466: 1434:Hydrogen peroxide 1291:Trichomonas tenax 1038: 1037: 617:Pasteur Institute 325:(periodontitis). 304: 303: 238:gingival bleeding 220:Diagnostic method 181:sleep deprivation 37:Medical condition 16:(Redirected from 4243: 4167: 4066: 3990: 3859:Ductal papilloma 3748: 3627: 3524:Non-odontogenic: 3509:Globulomaxillary 3448:Buccal exostosis 3413: 3357:Peri-implantitis 3203: 2919:Dentin dysplasia 2841: 2817:Verruca vulgaris 2712:Mucosal melanoma 2559:Darier's disease 2534:Behçet's disease 2504: 2460:Bednar's aphthae 2444: 2332: 2318:Trumpeter's wart 2240: 2225: 2218: 2211: 2202: 2027: 1983: 1958:Borrelia parkeri 1952:Borrelia duttoni 1946:Borrelia hermsii 1924:Neuroborreliosis 1919:Erythema migrans 1908:Borrelia afzelii 1830: 1821: 1788: 1781: 1774: 1765: 1753:Prosthodontology 1712:Dennis P. Tarnow 1657:Robert Gottsegen 1476: 1328:Furcation defect 1161: 1065: 1058: 1051: 1042: 942: 930: 929: 921: 915: 914: 912: 911: 896: 890: 889: 879: 855: 849: 848: 830: 799: 798: 782: 772: 745: 744: 734: 710: 662:is compromised. 629:Vincent's angina 625:palatine tonsils 387:Severe gum pain. 66: 40: 21: 4251: 4250: 4246: 4245: 4244: 4242: 4241: 4240: 4211: 4210: 4209: 4200: 4172: 4157: 4113:Ludwig's angina 4074: 4056: 4015:Mouth breathing 4001: 3980: 3801:Pneumoparotitis 3774:Frey's syndrome 3755: 3753:Salivary glands 3738: 3646: 3617: 3596:Phoenix abscess 3429: 3425:hard tissues – 3403: 3325:Hypercementosis 3244:Cementoblastoma 3230: 3193: 2907:Dens evaginatus 2861: 2831: 2783:Denture-related 2768:Plasmoacanthoma 2694:Keratoacanthoma 2515: 2513:Lining of mouth 2494: 2490:Torus palatinus 2451: 2434: 2415:Lingual thyroid 2373:Fissured tongue 2363:Crenated tongue 2339: 2322: 2308:Nasolabial cyst 2293:Herpes labialis 2247: 2234: 2229: 2199: 2194: 2189:Haverhill fever 2137: 2085: 2008: 1968: 1885: 1825:Spirochaetaceae 1810: 1792: 1762: 1757: 1731: 1662:Gary Greenstein 1626: 1505: 1463: 1392: 1363:Occlusal trauma 1338:Gingival pocket 1296: 1212: 1152: 1123:Gingival sulcus 1118:Gingival fibers 1076: 1069: 1039: 1034: 1033: 1010: 1009: 953: 939: 934: 933: 923: 922: 918: 909: 907: 898: 897: 893: 857: 856: 852: 845: 832: 831: 802: 795: 774: 773: 748: 712: 711: 694: 689: 672: 597: 580: 564: 552:pain medication 536: 520: 504: 448: 381: 340:, particularly 187:, pre-existing 153:immune response 38: 35: 28: 23: 22: 18:Fusospirillosis 15: 12: 11: 5: 4249: 4247: 4239: 4238: 4236:Trench warfare 4233: 4228: 4223: 4213: 4212: 4206: 4205: 4202: 4201: 4199: 4198: 4193: 4188: 4183: 4181:Eagle syndrome 4177: 4174: 4173: 4170: 4163: 4162: 4159: 4158: 4156: 4155: 4150: 4145: 4140: 4135: 4130: 4125: 4120: 4115: 4110: 4105: 4103:Cystic hygroma 4100: 4095: 4090: 4085: 4079: 4076: 4075: 4069: 4062: 4061: 4058: 4057: 4055: 4054: 4049: 4048: 4047: 4042: 4037: 4032: 4027: 4017: 4012: 4006: 4003: 4002: 3993: 3986: 3985: 3982: 3981: 3979: 3978: 3973: 3971:Sialolithiasis 3968: 3963: 3958: 3953: 3948: 3947: 3946: 3941: 3931: 3926: 3925: 3924: 3919: 3914: 3909: 3904: 3902:Adenocarcinoma 3899: 3891: 3886: 3881: 3876: 3871: 3869:Myoepithelioma 3866: 3861: 3856: 3851: 3838: 3833: 3828: 3823: 3818: 3813: 3808: 3803: 3798: 3797: 3796: 3786: 3781: 3776: 3771: 3766: 3760: 3757: 3756: 3751: 3744: 3743: 3740: 3739: 3737: 3736: 3735: 3734: 3729: 3719: 3714: 3713: 3712: 3707: 3702: 3697: 3692: 3687: 3682: 3677: 3667: 3662: 3657: 3651: 3648: 3647: 3630: 3623: 3622: 3619: 3618: 3616: 3615: 3610: 3605: 3600: 3599: 3598: 3588: 3583: 3578: 3577: 3576: 3571: 3566: 3556: 3551: 3546: 3545: 3544: 3542:Traumatic bone 3539: 3537:Median palatal 3534: 3529: 3521: 3516: 3511: 3506: 3501: 3496: 3491: 3475: 3470: 3465: 3460: 3455: 3450: 3445: 3440: 3434: 3431: 3430: 3416: 3409: 3408: 3405: 3404: 3402: 3401: 3396: 3391: 3390: 3389: 3384: 3379: 3369: 3364: 3359: 3354: 3349: 3348: 3347: 3337: 3332: 3330:Hypocementosis 3327: 3322: 3317: 3316: 3315: 3310: 3305: 3295: 3290: 3285: 3280: 3279: 3278: 3273: 3263: 3258: 3253: 3252: 3251: 3241: 3235: 3232: 3231: 3206: 3199: 3198: 3195: 3194: 3192: 3191: 3190: 3189: 3184: 3179: 3174: 3164: 3163: 3162: 3152: 3151: 3150: 3145: 3140: 3135: 3125: 3120: 3115: 3110: 3105: 3100: 3095: 3090: 3085: 3080: 3079: 3078: 3068: 3067: 3066: 3064:Neonatal teeth 3056: 3051: 3050: 3049: 3039: 3038: 3037: 3027: 3022: 3017: 3012: 3011: 3010: 3000: 2999: 2998: 2988: 2983: 2978: 2973: 2968: 2963: 2962: 2961: 2951: 2946: 2944:Ectopic enamel 2941: 2936: 2931: 2926: 2921: 2916: 2915: 2914: 2904: 2899: 2894: 2893: 2892: 2882: 2877: 2872: 2866: 2863: 2862: 2844: 2837: 2836: 2833: 2832: 2830: 2829: 2824: 2819: 2814: 2813: 2812: 2802: 2797: 2792: 2791: 2790: 2785: 2780: 2770: 2765: 2760: 2759: 2758: 2748: 2747: 2746: 2739:Oral melanosis 2736: 2731: 2730: 2729: 2724: 2719: 2714: 2709: 2704: 2696: 2691: 2678: 2673: 2668: 2663: 2658: 2653: 2648: 2643: 2638: 2633: 2628: 2623: 2618: 2613: 2608: 2603: 2598: 2593: 2588: 2587: 2586: 2576: 2571: 2566: 2561: 2556: 2551: 2546: 2541: 2539:Bohn's nodules 2536: 2531: 2526: 2524:Amalgam tattoo 2520: 2517: 2516: 2507: 2500: 2499: 2496: 2495: 2493: 2492: 2487: 2482: 2477: 2472: 2467: 2462: 2456: 2453: 2452: 2447: 2440: 2439: 2436: 2435: 2433: 2432: 2427: 2422: 2417: 2412: 2407: 2402: 2401: 2400: 2395: 2390: 2380: 2375: 2370: 2365: 2360: 2355: 2350: 2344: 2341: 2340: 2335: 2328: 2327: 2324: 2323: 2321: 2320: 2315: 2310: 2305: 2300: 2295: 2290: 2285: 2280: 2275: 2274: 2273: 2268: 2263: 2252: 2249: 2248: 2243: 2236: 2235: 2230: 2228: 2227: 2220: 2213: 2205: 2196: 2195: 2193: 2192: 2185:Rat-bite fever 2175: 2174: 2167: 2160: 2147: 2145: 2143:Fusobacteriota 2139: 2138: 2136: 2135: 2128: 2121: 2114: 2107: 2099: 2097: 2091: 2090: 2087: 2086: 2084: 2083: 2082: 2081: 2076: 2071: 2058: 2057: 2050: 2037: 2035: 2024: 2018: 2017: 2014: 2013: 2010: 2009: 2007: 2006: 1993: 1991: 1980: 1978:Leptospiraceae 1974: 1973: 1970: 1969: 1967: 1966: 1942: 1929: 1928: 1927: 1926: 1921: 1916: 1897: 1895: 1887: 1886: 1884: 1883: 1876: 1864: 1863: 1862: 1857: 1840: 1838: 1827: 1818: 1812: 1811: 1803:proteobacteria 1793: 1791: 1790: 1783: 1776: 1768: 1759: 1758: 1756: 1755: 1750: 1748:Orthodontology 1745: 1739: 1737: 1733: 1732: 1730: 1729: 1724: 1719: 1714: 1709: 1704: 1699: 1694: 1689: 1684: 1679: 1674: 1669: 1664: 1659: 1654: 1649: 1644: 1638: 1636: 1632: 1631: 1628: 1627: 1625: 1624: 1623: 1622: 1617: 1612: 1607: 1599: 1594: 1589: 1584: 1579: 1574: 1569: 1564: 1559: 1554: 1549: 1544: 1539: 1534: 1529: 1524: 1519: 1513: 1511: 1507: 1506: 1504: 1503: 1498: 1493: 1488: 1482: 1480: 1473: 1469: 1468: 1465: 1464: 1462: 1461: 1456: 1451: 1446: 1441: 1436: 1431: 1426: 1421: 1416: 1411: 1406: 1400: 1398: 1394: 1393: 1391: 1390: 1385: 1380: 1375: 1370: 1365: 1360: 1355: 1350: 1345: 1340: 1335: 1330: 1325: 1320: 1315: 1310: 1304: 1302: 1298: 1297: 1295: 1294: 1287: 1279: 1272: 1265: 1258: 1251: 1244: 1237: 1230: 1222: 1220: 1214: 1213: 1211: 1210: 1205: 1200: 1195: 1190: 1185: 1180: 1175: 1169: 1167: 1158: 1154: 1153: 1151: 1150: 1145: 1140: 1135: 1130: 1125: 1120: 1115: 1110: 1105: 1100: 1098:Biologic width 1095: 1090: 1084: 1082: 1078: 1077: 1073:Periodontology 1070: 1068: 1067: 1060: 1053: 1045: 1036: 1035: 1032: 1031: 1019: 1018: 1016: 1012: 1011: 1008: 1007: 996: 985: 970: 954: 949: 948: 946: 945:Classification 938: 937:External links 935: 932: 931: 916: 891: 850: 843: 800: 793: 746: 691: 690: 688: 685: 684: 683: 678: 671: 668: 596: 593: 579: 576: 563: 560: 535: 532: 519: 518:Classification 516: 503: 500: 454:that includes 447: 444: 417: 416: 413: 403: 402: 391: 388: 380: 377: 342:Fusobacteriota 302: 301: 292: 288: 287: 282: 278: 277: 260: 254: 253: 246:pseudomembrane 222: 216: 215: 162: 156: 155: 126: 122: 121: 118: 112: 111: 91: 85: 84: 82:Periodontology 79: 73: 72: 68: 67: 59: 58: 49: 45: 44: 36: 26: 24: 14: 13: 10: 9: 6: 4: 3: 2: 4248: 4237: 4234: 4232: 4229: 4227: 4224: 4222: 4219: 4218: 4216: 4197: 4194: 4192: 4189: 4187: 4184: 4182: 4179: 4178: 4175: 4168: 4164: 4154: 4151: 4149: 4146: 4144: 4141: 4139: 4136: 4134: 4131: 4129: 4126: 4124: 4121: 4119: 4116: 4114: 4111: 4109: 4106: 4104: 4101: 4099: 4096: 4094: 4091: 4089: 4086: 4084: 4083:Actinomycosis 4081: 4080: 4077: 4073: 4067: 4063: 4053: 4050: 4046: 4043: 4041: 4038: 4036: 4033: 4031: 4028: 4026: 4023: 4022: 4021: 4018: 4016: 4013: 4011: 4008: 4007: 4004: 4000: 3996: 3991: 3987: 3977: 3974: 3972: 3969: 3967: 3964: 3962: 3961:Sialodochitis 3959: 3957: 3954: 3952: 3949: 3945: 3942: 3940: 3937: 3936: 3935: 3932: 3930: 3927: 3923: 3920: 3918: 3915: 3913: 3910: 3908: 3905: 3903: 3900: 3898: 3895: 3892: 3890: 3887: 3885: 3882: 3880: 3877: 3875: 3872: 3870: 3867: 3865: 3862: 3860: 3857: 3855: 3852: 3850: 3847: 3844: 3843: 3842: 3839: 3837: 3834: 3832: 3829: 3827: 3824: 3822: 3819: 3817: 3814: 3812: 3809: 3807: 3804: 3802: 3799: 3795: 3792: 3791: 3790: 3787: 3785: 3782: 3780: 3777: 3775: 3772: 3770: 3767: 3765: 3762: 3761: 3758: 3754: 3749: 3745: 3733: 3730: 3728: 3725: 3724: 3723: 3720: 3718: 3715: 3711: 3708: 3706: 3703: 3701: 3698: 3696: 3693: 3691: 3688: 3686: 3683: 3681: 3678: 3676: 3673: 3672: 3671: 3668: 3666: 3663: 3661: 3658: 3656: 3653: 3652: 3649: 3645: 3641: 3640:malocclusions 3637: 3633: 3628: 3624: 3614: 3611: 3609: 3608:Stafne defect 3606: 3604: 3601: 3597: 3594: 3593: 3592: 3589: 3587: 3584: 3582: 3579: 3575: 3572: 3570: 3567: 3565: 3562: 3561: 3560: 3559:Osteonecrosis 3557: 3555: 3554:Osteomyelitis 3552: 3550: 3547: 3543: 3540: 3538: 3535: 3533: 3530: 3528: 3525: 3522: 3520: 3517: 3515: 3512: 3510: 3507: 3505: 3502: 3500: 3497: 3495: 3492: 3490: 3487: 3485: 3481: 3480: 3479: 3476: 3474: 3471: 3469: 3466: 3464: 3461: 3459: 3456: 3454: 3451: 3449: 3446: 3444: 3441: 3439: 3436: 3435: 3432: 3428: 3427:Bones of jaws 3424: 3420: 3414: 3410: 3400: 3397: 3395: 3392: 3388: 3385: 3383: 3380: 3378: 3375: 3374: 3373: 3372:Periodontitis 3370: 3368: 3365: 3363: 3360: 3358: 3355: 3353: 3352:Pericoronitis 3350: 3346: 3343: 3342: 3341: 3338: 3336: 3333: 3331: 3328: 3326: 3323: 3321: 3318: 3314: 3311: 3309: 3308:Granulomatous 3306: 3304: 3301: 3300: 3299: 3296: 3294: 3291: 3289: 3286: 3284: 3281: 3277: 3274: 3272: 3269: 3268: 3267: 3264: 3262: 3261:Eruption cyst 3259: 3257: 3254: 3250: 3247: 3246: 3245: 3242: 3240: 3237: 3236: 3233: 3229: 3225: 3221: 3217: 3213: 3209: 3204: 3200: 3188: 3185: 3183: 3180: 3178: 3175: 3173: 3170: 3169: 3168: 3165: 3161: 3158: 3157: 3156: 3153: 3149: 3146: 3144: 3141: 3139: 3136: 3134: 3131: 3130: 3129: 3126: 3124: 3121: 3119: 3116: 3114: 3111: 3109: 3106: 3104: 3101: 3099: 3096: 3094: 3091: 3089: 3088:Pulp necrosis 3086: 3084: 3081: 3077: 3074: 3073: 3072: 3069: 3065: 3062: 3061: 3060: 3057: 3055: 3052: 3048: 3047:Dens in dente 3045: 3044: 3043: 3040: 3036: 3033: 3032: 3031: 3028: 3026: 3023: 3021: 3018: 3016: 3013: 3009: 3006: 3005: 3004: 3001: 2997: 2994: 2993: 2992: 2989: 2987: 2984: 2982: 2979: 2977: 2974: 2972: 2969: 2967: 2964: 2960: 2957: 2956: 2955: 2952: 2950: 2947: 2945: 2942: 2940: 2939:Discoloration 2937: 2935: 2932: 2930: 2927: 2925: 2922: 2920: 2917: 2913: 2910: 2909: 2908: 2905: 2903: 2900: 2898: 2895: 2891: 2888: 2887: 2886: 2883: 2881: 2878: 2876: 2873: 2871: 2868: 2867: 2864: 2859: 2855: 2851: 2847: 2842: 2838: 2828: 2825: 2823: 2820: 2818: 2815: 2811: 2808: 2807: 2806: 2803: 2801: 2798: 2796: 2793: 2789: 2786: 2784: 2781: 2779: 2776: 2775: 2774: 2771: 2769: 2766: 2764: 2761: 2757: 2754: 2753: 2752: 2749: 2745: 2742: 2741: 2740: 2737: 2735: 2732: 2728: 2725: 2723: 2720: 2718: 2715: 2713: 2710: 2708: 2705: 2703: 2700: 2697: 2695: 2692: 2690: 2687: 2684: 2683: 2682: 2679: 2677: 2674: 2672: 2669: 2667: 2664: 2662: 2659: 2657: 2654: 2652: 2649: 2647: 2646:Lichen planus 2644: 2642: 2639: 2637: 2634: 2632: 2629: 2627: 2624: 2622: 2621:Herpes zoster 2619: 2617: 2614: 2612: 2609: 2607: 2604: 2602: 2599: 2597: 2596:Fordyce spots 2594: 2592: 2589: 2585: 2582: 2581: 2580: 2577: 2575: 2574:Erythroplakia 2572: 2570: 2567: 2565: 2562: 2560: 2557: 2555: 2552: 2550: 2547: 2545: 2542: 2540: 2537: 2535: 2532: 2530: 2527: 2525: 2522: 2521: 2518: 2514: 2510: 2505: 2501: 2491: 2488: 2486: 2483: 2481: 2478: 2476: 2473: 2471: 2468: 2466: 2463: 2461: 2458: 2457: 2454: 2450: 2445: 2441: 2431: 2428: 2426: 2423: 2421: 2418: 2416: 2413: 2411: 2408: 2406: 2403: 2399: 2396: 2394: 2391: 2389: 2386: 2385: 2384: 2381: 2379: 2376: 2374: 2371: 2369: 2366: 2364: 2361: 2359: 2358:Caviar tongue 2356: 2354: 2351: 2349: 2348:Ankyloglossia 2346: 2345: 2342: 2338: 2333: 2329: 2319: 2316: 2314: 2313:Sun poisoning 2311: 2309: 2306: 2304: 2301: 2299: 2296: 2294: 2291: 2289: 2286: 2284: 2281: 2279: 2276: 2272: 2269: 2267: 2264: 2262: 2259: 2258: 2257: 2254: 2253: 2250: 2246: 2241: 2237: 2233: 2226: 2221: 2219: 2214: 2212: 2207: 2206: 2203: 2190: 2186: 2182: 2181: 2177: 2176: 2173: 2172: 2168: 2166: 2165: 2161: 2158: 2154: 2153: 2149: 2148: 2146: 2144: 2140: 2134: 2133: 2129: 2127: 2126: 2122: 2120: 2119: 2115: 2113: 2112: 2108: 2106: 2105: 2101: 2100: 2098: 2096: 2092: 2080: 2077: 2075: 2072: 2070: 2067: 2066: 2065: 2064: 2060: 2059: 2056: 2055: 2051: 2048: 2044: 2043: 2039: 2038: 2036: 2034: 2033: 2028: 2025: 2023: 2019: 2004: 2003:Leptospirosis 2000: 1999: 1995: 1994: 1992: 1990: 1989: 1984: 1981: 1979: 1975: 1964: 1960: 1959: 1954: 1953: 1948: 1947: 1943: 1940: 1936: 1935: 1931: 1930: 1925: 1922: 1920: 1917: 1915: 1912: 1911: 1910: 1909: 1904: 1903: 1899: 1898: 1896: 1894: 1893: 1888: 1882: 1881: 1877: 1874: 1870: 1869: 1865: 1861: 1858: 1856: 1852: 1849: 1848: 1847: 1846: 1842: 1841: 1839: 1837: 1836: 1831: 1828: 1826: 1822: 1819: 1817: 1816:Spirochaetota 1813: 1808: 1804: 1800: 1799:gram negative 1796: 1789: 1784: 1782: 1777: 1775: 1770: 1769: 1766: 1754: 1751: 1749: 1746: 1744: 1743:Endodontology 1741: 1740: 1738: 1734: 1728: 1727:W. J. Younger 1725: 1723: 1720: 1718: 1715: 1713: 1710: 1708: 1705: 1703: 1700: 1698: 1695: 1693: 1690: 1688: 1687:Carl E. Misch 1685: 1683: 1680: 1678: 1675: 1673: 1670: 1668: 1665: 1663: 1660: 1658: 1655: 1653: 1650: 1648: 1645: 1643: 1640: 1639: 1637: 1633: 1621: 1618: 1616: 1613: 1611: 1608: 1606: 1603: 1602: 1600: 1598: 1595: 1593: 1590: 1588: 1585: 1583: 1580: 1578: 1575: 1573: 1570: 1568: 1565: 1563: 1560: 1558: 1555: 1553: 1550: 1548: 1545: 1543: 1540: 1538: 1535: 1533: 1530: 1528: 1525: 1523: 1520: 1518: 1515: 1514: 1512: 1508: 1502: 1499: 1497: 1494: 1492: 1489: 1487: 1484: 1483: 1481: 1477: 1474: 1470: 1460: 1457: 1455: 1452: 1450: 1447: 1445: 1442: 1440: 1437: 1435: 1432: 1430: 1427: 1425: 1422: 1420: 1417: 1415: 1412: 1410: 1407: 1405: 1402: 1401: 1399: 1395: 1389: 1386: 1384: 1381: 1379: 1378:Periodontitis 1376: 1374: 1371: 1369: 1366: 1364: 1361: 1359: 1356: 1354: 1351: 1349: 1346: 1344: 1341: 1339: 1336: 1334: 1331: 1329: 1326: 1324: 1321: 1319: 1316: 1314: 1311: 1309: 1306: 1305: 1303: 1299: 1293: 1292: 1288: 1285: 1284: 1280: 1278: 1277: 1273: 1271: 1270: 1266: 1264: 1263: 1259: 1257: 1256: 1255:P. intermedia 1252: 1250: 1249: 1248:P. gingivalis 1245: 1243: 1242: 1238: 1236: 1235: 1231: 1229: 1228: 1224: 1223: 1221: 1219: 1215: 1209: 1206: 1204: 1201: 1199: 1196: 1194: 1193:Periodontosis 1191: 1189: 1186: 1184: 1181: 1179: 1176: 1174: 1171: 1170: 1168: 1166: 1162: 1159: 1155: 1149: 1146: 1144: 1141: 1139: 1136: 1134: 1131: 1129: 1126: 1124: 1121: 1119: 1116: 1114: 1111: 1109: 1106: 1104: 1101: 1099: 1096: 1094: 1093:Alveolar bone 1091: 1089: 1086: 1085: 1083: 1079: 1074: 1066: 1061: 1059: 1054: 1052: 1047: 1046: 1043: 1030: 1026: 1025: 1021: 1020: 1017: 1013: 1006: 1002: 1001: 997: 995: 991: 990: 986: 984: 980: 979: 975: 971: 969: 965: 964: 960: 956: 955: 952: 947: 943: 936: 928:. p. 31. 927: 920: 917: 906:on 2011-06-05 905: 901: 895: 892: 887: 883: 878: 873: 869: 865: 861: 854: 851: 846: 844:9780443068188 840: 836: 829: 827: 825: 823: 821: 819: 817: 815: 813: 811: 809: 807: 805: 801: 796: 794:9781405160995 790: 786: 781: 780: 771: 769: 767: 765: 763: 761: 759: 757: 755: 753: 751: 747: 742: 738: 733: 728: 724: 720: 716: 709: 707: 705: 703: 701: 699: 697: 693: 686: 682: 679: 677: 674: 673: 669: 667: 663: 661: 660:immune system 657: 653: 649: 644: 640: 637: 632: 630: 626: 622: 618: 614: 610: 606: 602: 594: 592: 588: 586: 577: 575: 573: 569: 561: 559: 557: 556:metronidazole 553: 549: 545: 541: 533: 531: 527: 525: 517: 515: 513: 509: 501: 499: 496: 494: 490: 486: 485:immune system 481: 479: 478: 473: 469: 468: 467:Fusobacterium 463: 462: 461:P. intermedia 457: 453: 445: 443: 441: 437: 433: 429: 425: 421: 414: 411: 408: 407: 406: 400: 396: 392: 389: 386: 385: 384: 378: 376: 374: 371:arose during 370: 366: 365:metronidazole 362: 358: 354: 349: 347: 343: 339: 335: 331: 326: 324: 320: 316: 312: 308: 300: 299:metronidazole 296: 293: 289: 286: 283: 279: 276: 272: 268: 264: 261: 259: 255: 251: 247: 243: 239: 235: 231: 227: 223: 221: 217: 214: 210: 206: 202: 198: 194: 191:, history of 190: 186: 183:, inadequate 182: 178: 174: 170: 166: 163: 161: 157: 154: 150: 146: 145:Fusobacterium 142: 138: 134: 130: 127: 123: 119: 117: 116:Complications 113: 110: 107: 103: 99: 95: 92: 90: 86: 83: 80: 78: 74: 69: 65: 60: 57: 53: 50: 46: 41: 33: 19: 4071: 3998: 3934:Sialadenitis 3893: 3845: 3710:Scissor bite 3705:Retrognathia 3690:Overeruption 3670:Malocclusion 3643: 3523: 3482: 3473:Micrognathia 3426: 3417:Periapical, 3303:Desquamative 3227: 3208:Periodontium 3182:Acid erosion 3123:Taurodontism 3054:Open contact 2966:Enamel pearl 2934:Dilaceration 2897:Concrescence 2698: 2685: 2512: 2465:Cleft palate 2425:Microglossia 2420:Macroglossia 2405:Glossoptosis 2303:Microcheilia 2298:Macrocheilia 2178: 2169: 2162: 2150: 2130: 2123: 2116: 2109: 2102: 2095:Bacteroidota 2061: 2052: 2040: 2030: 1996: 1986: 1956: 1950: 1944: 1932: 1914:Lyme disease 1906: 1900: 1890: 1878: 1866: 1843: 1833: 1717:Hom-Lay Wang 1702:Jørgen Slots 1672:Brian Mealey 1547:Gingivectomy 1449:Tetracycline 1444:Oral hygiene 1289: 1281: 1274: 1269:T. denticola 1267: 1262:T. forsythia 1260: 1253: 1246: 1241:F. nucleatum 1239: 1232: 1225: 1088:Periodontium 1022: 998: 987: 972: 957: 925: 919: 908:. Retrieved 904:the original 894: 867: 863: 853: 834: 778: 725:: S85–S102. 722: 718: 664: 645: 641: 636:trench mouth 633: 598: 589: 581: 578:Epidemiology 568:periodontium 565: 548:mouth rinses 544:oral hygiene 537: 528: 521: 505: 497: 493:malnutrition 482: 475: 465: 459: 449: 436:Cancrum oris 418: 404: 382: 369:trench mouth 368: 350: 327: 310: 306: 305: 285:oral hygiene 213:orthodontics 185:oral hygiene 173:malnutrition 160:Risk factors 56:Trench mouth 55: 51: 4128:Microstomia 4118:Macrostomia 4108:Gnathophyma 4025:Catathrenia 4020:Sleep apnea 3951:Sialectasis 3494:Dentigerous 3484:Odontogenic 3313:Plasma cell 3249:Gigantiform 3025:Microdontia 3015:Macrodontia 2986:Hyperdontia 2681:Oral cancer 2641:Leukoplakia 2549:Candidiasis 2509:Oral mucosa 2430:Rhabdomyoma 2410:Hypoglossia 2271:Plasma cell 2047:Psittacosis 2022:Chlamydiota 1697:Jay Seibert 1647:Frank Beube 1486:Debridement 1276:Red complex 1024:MedlinePlus 681:Mouth ulcer 676:Canker sore 540:debridement 472:spirochetes 470:as well as 410:Foul breath 373:World War I 361:antibiotics 248:formation, 211:ethnicity, 149:Spirochetes 141:Selenomonas 120:Progression 48:Other names 32:Trenchmouth 4215:Categories 4088:Angioedema 3894:Malignant: 3874:Oncocytoma 3700:Prognathia 3489:periapical 3468:Microgenia 3419:mandibular 3377:Aggressive 3298:Gingivitis 3239:Cementicle 3177:Abfraction 3167:Tooth wear 3160:Edentulism 3155:Tooth loss 3108:Resorption 3093:Pulp polyp 3076:Pulp stone 3020:Meth mouth 2991:Hypodontia 2981:Gemination 2912:Talon cusp 2805:Ulceration 2773:Stomatitis 2751:Pemphigoid 2699:Malignant: 2651:Linea alba 2636:Leukoedema 2616:Herpangina 2584:Giant-cell 1988:Leptospira 1667:Jan Lindhe 1592:Sinus lift 1522:Bone graft 1409:Ante's law 1348:Gingivitis 1318:Edentulism 1000:DiseasesDB 910:2010-02-13 687:References 656:prevalence 508:leukocytes 474:, such as 346:spirochete 330:gingivitis 281:Prevention 189:gingivitis 98:bad breath 3956:Sialocele 3939:Parotitis 3680:Open bite 3675:Crossbite 3453:Cherubism 3423:maxillary 3256:Cementoma 3187:Attrition 3003:Impaction 2971:Fluorosis 2880:Anodontia 2875:Ankylosis 2763:Pemphigus 2383:Glossitis 2278:Cleft lip 2256:Cheilitis 2069:Chlamydia 2032:Chlamydia 1835:Treponema 1472:Treatment 1454:Triclosan 1439:Mouthwash 1286:(amoebic) 1218:Infection 1165:Diagnoses 1148:Stippling 741:0022-3492 634:The term 562:Prognosis 534:Treatment 502:Diagnosis 477:Treponema 456:anaerobes 395:ulcerated 363:(usually 348:species. 291:Treatment 250:halitosis 137:Treponema 77:Specialty 4231:Necrosis 3966:Sialosis 3917:Lymphoma 3789:Mucocele 3685:Overbite 3438:Agnathia 3399:Teething 3224:alveolus 3220:cementum 3172:Abrasion 3148:Occlusal 3133:Avulsion 3098:Pulpitis 3042:Odontoma 2788:Herpetic 2778:Aphthous 2288:Eclabium 2079:Trachoma 1892:Borrelia 1851:Syphilis 1610:Membrane 1429:Flossing 1414:Brushing 1323:Fremitus 1308:Calculus 1103:Cementum 886:19979715 670:See also 601:Xenophon 512:leukemia 458:such as 440:HIV/AIDS 226:necrosis 106:bleeding 89:Symptoms 4052:Snoring 4010:Bruxism 3846:Benign: 3695:Overjet 3655:Bruxism 3549:Osteoma 3387:Chronic 3212:gingiva 2686:Benign: 2579:Fibroma 2266:Angular 2261:Actinic 1797:due to 1605:Curette 1510:Surgery 1157:Disease 1113:Gingiva 1081:Anatomy 994:D005892 877:2017821 787:, 459. 648:sequela 621:pharynx 595:History 585:measles 426:and/or 420:Malaise 201:alcohol 197:tobacco 3794:Ranula 3266:Epulis 3128:Trauma 2976:Fusion 2885:Caries 2858:enamel 2854:dentin 2449:Palate 2337:Tongue 1620:Scaler 1601:Tools 1383:Plaque 1029:001044 884:  874:  841:  791:  739:  605:scurvy 446:Causes 125:Causes 4171:Other 2846:Teeth 1873:Pinta 1855:bejel 1615:Probe 1301:Other 1005:13866 968:A69.1 424:fever 397:with 230:ulcer 209:white 205:youth 203:use, 147:spp, 102:fever 4133:Noma 3638:and 3421:and 3226:) – 2850:pulp 2245:Lips 1860:Yaws 1801:non- 989:MeSH 978:9-CM 882:PMID 839:ISBN 789:ISBN 737:ISSN 623:and 550:and 464:and 399:dead 359:and 344:and 242:pain 199:and 169:AIDS 109:gums 94:pain 1807:BV4 983:101 974:ICD 959:ICD 872:PMC 785:413 727:doi 652:HIV 650:of 587:). 332:or 232:of 165:HIV 131:by 4217:: 3997:– 3642:– 3634:, 3222:, 3218:, 3214:, 2856:, 2852:, 2511:– 1027:: 1003:: 992:: 981:: 966:: 963:10 880:. 868:10 866:. 862:. 803:^ 749:^ 735:. 723:89 721:. 717:. 695:^ 611:. 480:. 442:. 422:, 311:NG 297:, 273:, 269:, 265:, 244:, 240:, 236:; 228:, 207:, 195:, 179:, 175:, 171:, 143:, 139:, 135:, 104:, 100:, 96:, 54:, 52:NG 3486:: 3210:( 2860:) 2848:( 2224:e 2217:t 2210:v 2191:) 2187:/ 2183:( 2159:) 2155:( 2049:) 2045:( 2005:) 2001:( 1965:) 1961:( 1955:/ 1949:/ 1941:) 1937:( 1905:/ 1875:) 1871:( 1853:/ 1809:) 1805:( 1787:e 1780:t 1773:v 1075:) 1064:e 1057:t 1050:v 976:- 961:- 951:D 913:. 888:. 847:. 797:. 743:. 729:: 412:. 309:( 252:) 167:/ 34:. 20:)

Index

Fusospirillosis
Trenchmouth

Specialty
Periodontology
Symptoms
pain
bad breath
fever
bleeding
gums
Complications
bacterial infection
Prevotella intermedia
Treponema
Selenomonas
Fusobacterium
Spirochetes
immune response
Risk factors
HIV
AIDS
malnutrition
psychological stress
sleep deprivation
oral hygiene
gingivitis
necrotizing periodontal disease
tobacco
alcohol

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