Idiopathic Acute Necrotizing Gingivitis

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Nov 6, 2015
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This happened to me a few years ago, and it remained an open mystery as to what caused this to happen. I have an appointment with a new dentist in the AM, and that lead me to decide to post this puzzle here to see if anyone has experienced this, or if any of the experts have seen something like this before.

Dental history in brief: until I was 25, I was insured through my parents insurance. Being born with crooked teeth herself, my mother made it a point to do whatever she could to ensure I had the best oral hygiene a kid can realistically had, and definitely the best care that (at the time) was available... started on fluoride treatments at 5 years old, regular dental checkups, made to brush my teeth after every meal in addition to when I woke up and before I went to bed...and as soon as she found out about Sonicare brushes, it was with one of those.... Orthodontic work started when I was 9 to pull some impacted baby teeth, and after years of torturous contraptions, a few years with braces, and several years of follow up retainer use every night, I absolutely had perfect effing teeth. Like, movie star smile perfect.

After 25 I never had great insurance, but managed to get a checkup and a cleaning once a year or so. Every time - in despite of my smoking and coffee consumption - the dental staff would remark how great my teeth were. I have never had a cavity in my entire life.

Suddenly, when I was 28, I had a strange toothache at work. Now, sometimes if I get a nasty cold that turns into a sinus infection, that will cause jaw pain. So I thought perhaps that's what it was at first. By the time I took my lunch break, I noticed some things that ruled that out. Firstly, I didn't have any other symptoms of a cold. Second, the pain was definitely not coming from the lymph glands around my lower jaw. Rather, it was emanating from my upper gums around my canine on the left side. When I realized it hurt so bad that I couldn't even take a bite of food, I finally decided to look in the mirror (I know...obvious...but I have a tendency to get hyperfocused on my work). That's when I realized that my gum line was in fact red and swollen above that tooth.

I chalked it up to flossing too rigorously...even though I didn't actually recall doing so. I thought perhaps it was the fact that I was using a new brand of disposable flosser....I don't know....denial logic. Throughout that night I started to feel ill. By the time I went to sleep, the swelling had spread to both sides (symmetrical) and to the bottom gums as well in the same vicinity. I took some tylenol and slept. When I woke up, it HURT.

I brushed my teeth lightly... and noticed these little white spots where the painful spots were between my teeth. I went to work. The pain increased. I started to develop a fever. I developed a nasty taste in my mouth, so I rinsed with hydrogen peroxide and lightly brushed. Oh boy....those spots that were white were now mostly black. Some of them were a little bloody...and one little tiny chunk of my gums actually came right off onto my toothbrush with no blood at all. At that point, I went to the University ER (late night, and i knew they had a dentist on call).

The dentist had called out sick. Three different doctors came in to look and none of them knew what to make of it. They took swabs. My fever had spiked at about 104. They sent me home with percocet, antibiotics AND antifungals, and wished me the best. Someone from the dental school was supposed to call me when the results came back....but they never did...and the only phone number I had for the dental school turned out to be useless (turns out this is an issue at UW).

The next day, as soon as it had presented, it started to clear up and I felt better. Two days later I was able to eat and function normally again. Still have a little piece of my gum missing.

This never happened to me again...however, that spot by my canine where that chunk of my gums just fell apart has in recent months (this is years later) developed a tiny little black dot right at the gumline.

So. Any ideas?
 

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