A patient presents with ANUG with lesions throughout the mouth, fetid breath, and destroyed interdental papillae. The treatment of choice includes all of the following EXCEPT:

Correct answer: B. Incisional biopsy of necrotic tissue

• A. Chlorhexidine (0.12%) rinse provides antimicrobial support as an adjunct to mechanical therapy.
• B. Correct. Biopsy is NOT appropriate for ANUG — the diagnosis is clinical, and biopsying acutely necrotic, infected tissue is unnecessary and potentially harmful.
• C. Metronidazole is first-line antibacterial therapy for ANUG due to its excellent anaerobic coverage.
• D. Gentle initial debridement of necrotic tissue is appropriate after pain management.