Thirty six years of periodontal care: A case report

INTRODUCTION: In 1978 a 15 year old male was referred to a periodontal practice complaining of bleeding gums. CASE PRESENTATION: There was Necrotizing Ulcerative Gingivitis (NUG) (called Vincent's Infection at the time) superimposed upon Altered Passive Eruption (APE; then termed Delayed Passive Eruption). Immediate treatment was a course of Metronidazole followed by scaling and oral hygiene instruction. In 1981 a gingivectomy was carried out around the maxillary incisors and canines. The patient has been seen thereafter at intervals for oral hygiene care, prophylaxis and scaling (SPT; Supportive Periodontal Treatment) most recently in 2014. CONCLUSION: The potentially devastating effects of NUG combined with APE were successfully managed and oral health has subsequently been maintained through a programme of regular periodontal care. APE may be a predisposing factor to NUG, an acute necrotic lesion which, provided there are no systemic compromising complications, responds well to anti-microbial therapy combined with professional plaque and calculus removal, improved oral hygiene and meticulous home care.