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Prevalence and treatment of necrotizing ulcerative gingivitis (NUG) in the British Armed Forces: a case-control study.
Clin Oral Investig. 2017 Jul; 21(6):1935-1944.CO

Abstract

OBJECTIVES

Necrotizing ulcerative gingivitis (NUG) has been seen in military populations throughout history. This study aims to determine the prevalence, treatment modality and risk factors associated with NUG in the British Armed Forces.

MATERIALS AND METHODS

A whole population dataset of the British Armed Forces was searched to determine cases of NUG during the period 1 January to 31 December 2012. Individual case records were identified, and a case-control study undertaken with data gathered and analysed against a randomised control group, matched for age, sex and service.

RESULTS

A prevalence rate for NUG of 0.11 % was determined against the whole military population. The majority of cases received (alone or in combination) the following: oral hygiene instruction (66.5 %), antibiotics (64.4 %) and a mouthwash (58.1 %). Of the cases, 48.7 % received debridement. Analgesics were only prescribed in 8.4 % of the cases, and smoking cessation advice was only given in 10.7 % of the cases. Analysis of risk factors against the control group showed an increase in odds ratios for diagnosis of NUG of 3.4 (95 % CI 2.0-5.7) for current smokers and 7.3 (95 % CI 1.9-28.0) for individuals with an overall Basic Periodontal Examination (BPE) score of 3.

CONCLUSIONS

Whilst NUG is a rare disease, it is evident from this study that it still occurs within the British Armed Forces. A strong association was shown between NUG and current smokers and those cases with an overall BPE score of 3.

CLINICAL RELEVANCE

This study provides prevalence data for NUG in the British Armed Forces and description of its treatment and associated risk factors. Oral hygiene and smoking must be addressed in patients with NUG and prescribing protocols should be carefully followed.

Authors+Show Affiliations

Defence Medical Services, Ministry of Defence, London, UK.Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.Biostatistics Unit, UCL Eastman Dental Institute, London, UK.Defence Medical Services, Ministry of Defence, London, UK.Defence Medical Services, Ministry of Defence, London, UK.Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK. n.donos@qmul.ac.uk.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27830369

Citation

Dufty, J, et al. "Prevalence and Treatment of Necrotizing Ulcerative Gingivitis (NUG) in the British Armed Forces: a Case-control Study." Clinical Oral Investigations, vol. 21, no. 6, 2017, pp. 1935-1944.
Dufty J, Gkranias N, Petrie A, et al. Prevalence and treatment of necrotizing ulcerative gingivitis (NUG) in the British Armed Forces: a case-control study. Clin Oral Investig. 2017;21(6):1935-1944.
Dufty, J., Gkranias, N., Petrie, A., McCormick, R., Elmer, T., & Donos, N. (2017). Prevalence and treatment of necrotizing ulcerative gingivitis (NUG) in the British Armed Forces: a case-control study. Clinical Oral Investigations, 21(6), 1935-1944. https://doi.org/10.1007/s00784-016-1979-9
Dufty J, et al. Prevalence and Treatment of Necrotizing Ulcerative Gingivitis (NUG) in the British Armed Forces: a Case-control Study. Clin Oral Investig. 2017;21(6):1935-1944. PubMed PMID: 27830369.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence and treatment of necrotizing ulcerative gingivitis (NUG) in the British Armed Forces: a case-control study. AU - Dufty,J, AU - Gkranias,N, AU - Petrie,A, AU - McCormick,R, AU - Elmer,T, AU - Donos,N, Y1 - 2016/11/09/ PY - 2016/01/04/received PY - 2016/10/11/accepted PY - 2016/11/11/pubmed PY - 2018/5/10/medline PY - 2016/11/11/entrez KW - Armed forces KW - Military KW - NUG KW - Necrotizing ulcerative gingivitis SP - 1935 EP - 1944 JF - Clinical oral investigations JO - Clin Oral Investig VL - 21 IS - 6 N2 - OBJECTIVES: Necrotizing ulcerative gingivitis (NUG) has been seen in military populations throughout history. This study aims to determine the prevalence, treatment modality and risk factors associated with NUG in the British Armed Forces. MATERIALS AND METHODS: A whole population dataset of the British Armed Forces was searched to determine cases of NUG during the period 1 January to 31 December 2012. Individual case records were identified, and a case-control study undertaken with data gathered and analysed against a randomised control group, matched for age, sex and service. RESULTS: A prevalence rate for NUG of 0.11 % was determined against the whole military population. The majority of cases received (alone or in combination) the following: oral hygiene instruction (66.5 %), antibiotics (64.4 %) and a mouthwash (58.1 %). Of the cases, 48.7 % received debridement. Analgesics were only prescribed in 8.4 % of the cases, and smoking cessation advice was only given in 10.7 % of the cases. Analysis of risk factors against the control group showed an increase in odds ratios for diagnosis of NUG of 3.4 (95 % CI 2.0-5.7) for current smokers and 7.3 (95 % CI 1.9-28.0) for individuals with an overall Basic Periodontal Examination (BPE) score of 3. CONCLUSIONS: Whilst NUG is a rare disease, it is evident from this study that it still occurs within the British Armed Forces. A strong association was shown between NUG and current smokers and those cases with an overall BPE score of 3. CLINICAL RELEVANCE: This study provides prevalence data for NUG in the British Armed Forces and description of its treatment and associated risk factors. Oral hygiene and smoking must be addressed in patients with NUG and prescribing protocols should be carefully followed. SN - 1436-3771 UR - https://www.unboundmedicine.com/medline/citation/27830369/Prevalence_and_treatment_of_necrotizing_ulcerative_gingivitis_(NUG)_in_the_British_Armed_Forces:_a_case-control_study L2 - https://dx.doi.org/10.1007/s00784-016-1979-9 DB - PRIME DP - Unbound Medicine ER -