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We do not think ANUG is caused by bacterial infection. Of course there has to be a gingivitis first. But if you look carefully under phase contrast microscope you will clearly see the presence of the protozoan trichomonas, tenax, or vaginalis possibly, which seem to render this type of periodontitis very aggressive. Is smoking responsible, or stress? We believe it is not reliabe with stress as most of the time only front teeth are to be “stressed“! It seems to be more as a parasi
