This condition occurs in the presence of good plaque control and may be related to an immune deficiency


  • Actinobacillus (Haemophilus) actinomycetemcomitans is the main pathogen together with Capnocytophaga
    sp, Eikenella corrodens, and Bacteroides intermedius organisms

Clinical features

  • Progressive periodontal destruction; classically in the permanent incisor and first molar regions in the presence of good oral hygiene
  • The gingiva around the affected tooth may appear entirely normal, but deep pockets are detected on probing
  • Early tooth loss


  • Give instructions on oral hygiene
  • Oral rinses with mouthwash consisting of chlorhexidine solution 0.2% 3 times a day
  • Refer to a dentist for scaling, root planing, and polishing to remove plaque and calculus deposits