Aggressive periodontitis with streptococcal gingivitis with mechanical debridement of the root surfaces due to the presence of immunoglobulin and non- to disrupt the biofilm is effective in most patients immunoglobulin agents in its content.13 It also with AP.10 prevents the proteins and cells in oral mucosa from Tetracycline that was used by most of the H2O2 toxicity.14 At physiologic concentrations and researchers in previous studies was chosen neutral pH, it prevents the bacterial glycolysis by for chemotherapy because of its affectivity for inhibiting the pH and potentiates the antibacterial periodontal diseases and high secretion capacity defense mechanisms as a bacteriostatic agent.15,16 from gingival tissue.11 The patient was also treated It has been shown that the OHSCN/ OSCN value according to these recommendations. Although a had a stronger anti-streptococcal effect and successful and appropriate treatment was applied inhibited the bacterial growth very effectively if to the patient according to the recommendations it was sufficiently present enough in the saliva for AP, streptococcal inflammation increased the in pH values of 7.17 The pH of saliva increases worsening of the oral findings present in AP. with concomitant secretion of HCO3 with saliva Acute streptococcal gingivitis has been given secretion (5.5-7.5). The most important factor for little attention in the dental literature in general, the increase of the pH is the HCO3.18 Even though and in the periodontal literature in particular. Only saliva has all those beneficiary antimicrobial one well-documented study is cited in the medico- effects that were mentioned above, sometimes it dental literature.4 The treatment of choice for may not be sufficient enough to kill some specific streptococci infections is penicillin. Sulfonamides bacteria which can be available in oral pH values and broad spectrum antibiotics have also been of 6-8 and for streptococcus species which can used to treat streptococcal infections. Recognition, survive at a low pH and to continue producing identification of etiology, diagnosis of disease, and acid. In conclusion, using an antacid agent may treatment of acute gingivostomatitis are critically prove to be useful as an indicator of environmental important of untreated group A beta-hemolytic conditions in the oral cavity, and as a determinant streptococcal infection, which has many serious of treatment model among oral streptococci. complications.12 CONCLuSIONS In addition to this primary etiologic factor, other factors such as differentiation of saliva With this case report an alternative treatment composition can foster progression of this disease. option based on these data was demonstrated and In progression of this disease like other periodontal antacidtreatmentasadjunctivetotherecommended diseases, saliva plays important roles as a disease treatment modalities for streptococcus gingivitis marker and as a defense mechanism. was used. It can be said that oral antacid treatment Saliva has some antimicrobial activity against as well as conventional periodontal treatment may many different microorganisms. This is mainly be helpful in the treatment of oral infections due to Streptococcus. REFERENCES 1. Holmstrup P. Non-plaque-induced gingival lesions. Ann Periodontol 1999;4:20-29. 2. Pindborg JJ. Atlas of disease of the oral mucosa. 3th ed. Copenhagen: Munksgaard; 1980:24-25. 3. Lindhe J. Textbook of Clinical Periodontology. 2nd ed. Copenhagen: Munksgaard; 1992:92-128. 4. Littner MM, Dayan D, Kaffe I, Begleiter A, Gorsky M, Moskana D, Buchner A. Acute streptococcal gingivostomatitis. Report of five cases and review of the literature. Oral Surg Figure 5. Post-treatment clinical view of anterior Oral Med 1982;53:144-147. region of the oral cavity; observe reduction of 5. Carranza FA. Glickman’s Clinical Periodontology. 7th ed. gingival inflammation and acceptable gingival Philadelphia: W.B. Saunders Company; 1990:149-165. health. 254 European Journal of Dentistry