When It Comes to Gum Infections, the Immediate Danger Sign Isn’t Red, It’s Black

Necrotizing ulcerative periodontitis is a gum disease you have probably never heard of. Periodontitis is any condition of inflammation of the gums, usually caused by bacterial infection. Ulcerative periodontitis is a condition of inflammation that causes ulcers, or gaps in the outer layers of the gums that can allow infection to go down to your teeth-but the gum isn’t killed. Necrotizing ulcerative periodontitis, also known as NUP and black gum disease, is a condition of inflammation that causes the gums to “crater” and even kills the bone beneath them.

What are the warning signs that you may have NUP? Instead of reddish swelling that hurts, you have black craters that have no sensation at all. But before this happens you may have sudden, intense jaw pain, along with really awful bad breath, spontaneous bleeding, a metallic taste in the mouth (which stops when the bleeding stops), and cone-shaped indentations going deep into the gum line.

Is periodontitis the same thing as gingivitis? Black gum /NUP is not the same thing as gingivitis. In gingivitis, the inflammation and irritation is caused by the immune system itself. The immune system tries to get rid of accumulations of bacteria known as plaques by destroying the tissue in which they live. The immune system itself causes the destruction of the gums and loosens the teeth.

In black gum disease/NUP, the tiny black spots on the gums that can go deep into the jawbone are the result of tissue destruction by bacteria or molds, not by the body’s inflammatory processes. Microorganims such as strain of Streptococcus bacteria, a strain of Actinomycetes fungi, or an organism similar to syphilis (although not spread by sexual contact) do the actual destruction of tissue.

How do people get NUP? This condition most commonly occurs only if people abandon oral hygiene completely-no brushing, no flossing, no mouthwash. The people most likely to suffer this kind of oral infection are those who live in deserts, especially the Sahara, and people who lose the use of their hands but do not have assistance for personal care.

How is necrotizing ulcerative periodontitis treated? Treating black gum requires professional care. Your dentist can prescribe appropriate antibiotics, and remove infected tissues.

There can be serious health concerns if you leave this condition untreated. You may not only lose all your teeth and suffer serious damage to the bones underlying your face, the infection can also spread to your heart.

Prevention is key. If you don’t live in a tent in the Sahara desert, you don’t have to suffer ulcerative periodontitis. Brush after every meal, floss (wrapping the floss around the tooth and pulling back and forth, not pushing the floss into your gum), and regular dental checkups can stop this condition before it starts.

Selected References:

Savage, Amir; Eaton, Kenneth A.; Moles, David R.; Needleman, Ian (2009). “A systematic review of definitions of periodontitis and methods that have been used to identify this disease“. Journal of Clinical Periodontology 36 (6): 458-467.