Necrotizing Periodontitis in a Drug Abuser: a Case Report

Diagnosis of necrotizing periodontal diseases is based on clinical characteristics. Different predisposing factors could be related. A 34-year-old man visited a dental service due to pain in the right maxilla and bad breath for 10 days. He presented with adenopathy and general discomfort. He did not report any systemic alterations, stated that he used cocaine and crack daily for more than 5 years, and consumed alcohol. An intraoral examination revealed bone destruction with root exposure related to tooth 14 and a necrotic 0.5 cm ulcer in the palatine area near tooth 15. A periapical view confirmed bone loss. Debris were removed; the patient was prescribed amoxicillin and metronidazole for 7 days and was oriented about oral hygiene. He did not return. Drug abusers do not eat well or maintain dental hygiene. Every dental examination should begin with an anamnesis, considering abuse of drugs, with careful clinical oral examination.