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secondary to poor dental hygiene. 
Clinical presentation ranges from simple gingivitis (painless, red swelling of the gum margin which bleeds on contact) to acute necrotizing ulcerative gingivitis (painful bleeding gums with halitosis and punched-out ulcers on the gums).

''acute necrotizing ulcerative gingivitis'' 
    refer the patient to a dentist, meanwhile the following is recommended:
    oral metronidazole (or amoxil) for 3 days
    chlorhexidine (0.12% or 0.2%) or hydrogen peroxide 6% mouth wash
    simple analgesia