Necrotising Ulcerative Gingivitis — MFDS Part 1 MCQ
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Correct answer: A — Acute necrotising ulcerative gingivitis
Acute necrotising ulcerative gingivitis is the best diagnosis. Its characteristic presentation comprises acute gingival pain, ulceration and blunting or loss of the interdental papillae, grey slough over the ulcers and marked halitosis. It is associated with anaerobic fuso-spirochaetal bacteria and is more frequent with smoking, immunosuppression and inadequate oral hygiene. Primary herpetic gingivostomatitis produces diffuse gingivitis with multiple vesicles and ulcers rather than papillary necrosis. Aphthae typically affect non-keratinised mucosa without generalised gingivitis. Pemphigus vulgaris causes fragile bullae and widespread erosions, while erythema multiforme usually produces acute widespread ulceration with prominent haemorrhagic lip crusting.
Reference: Scottish Dental Clinical Effectiveness Programme. Prevention and Treatment of Periodontal Diseases in Primary Care, Acute conditions: Necrotising gingivitis and periodontitis. 2026. https://www.periodontalcare.sdcep.org.uk/guidance/managing-disease/other-periodontal-conditions/acute-conditions/