Acute necrotizing periodontal disease; an appraisal of therapy and a critical criterion.

I T is now thirty years since the dental profession was confronted with acute necrotizing periodontal disease as a major health problem from the stand­ point of incidence and wide distribution among the population, both military and civilian. The American soldier of World War I named the disease “ trench mouth.” It previously had been desig­ nated by the eponyms “Vincent’s infec­ tion” and “ Plaut’s angina.” The modern trend in nomenclature to name diseases by accurately descriptive designations has led to the development of more accep­ table and useful terms. Accordingly, the disease group entity under discussion in this report will be designated as “ necrotizing periodontal disease.” Included in this group are a wide range of involvements, differen­ tiated on several principles of disease classification. On the basis of tissues in­ volved, there are three classifications: necrotizing gingivitis, necrotizing perio­ dontitis and necrotizing stomatitis. On the basis of disease intensity, there arc also three classifications: acute, subacute and chronic. The logic for designating these oral diseases as periodontal is to be found in the fact that they always arise primarily in gingival sulci or under gingival flaps that are associated with partially erupted teeth. These designations do not take into account differences in causation. These differences in causation may serve as still