ANUG Microbiology — ORE Part 1 MCQ
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Correct answer: B — Fusiform bacteria and spirochaetes
Explanation lettering: D = shown as A · A = shown as B · B = shown as D
A is correct. Necrotising gingivitis is classically associated with a fusospirochaetal microbial complex: anaerobic fusiform organisms, including Fusobacterium species, together with oral spirochaetes, including Treponema species. SDCEP specifically describes necrotising gingivitis/periodontitis as caused by pathogenic fusiform bacteria and spirochaetes. Mutans streptococci and lactobacilli are principally associated with dental caries. Candida species cause oral candidosis, while herpesviruses cause primary herpetic gingivostomatitis rather than ANUG. Staphylococci and enterococci are not the characteristic flora of ANUG. The condition is polymicrobial, so the most accurate answer is a microbial group rather than a single organism.
Reference: Scottish Dental Clinical Effectiveness Programme. Management of Acute Dental Problems, section on necrotising gingivitis and periodontitis, March 2013. https://www.sdcep.org.uk/media/ixlpeakb/sdcep-madp-guidance-march-2013.pdf