Trench Mouth

September 8, 2023

By Dr. Stuart Fass

Trench mouth is an old term for what we now refer to as ANUG, or Acute Necrotizing Ulcerative Gingivitis. This is a very painful infection of the gums that can happen very quickly.

The symptoms include swollen and very tender gums that can bleed very easily when touched. The little points of gum tissue between the teeth are often missing and whitish patches appear on the surface of the gums. The onset of symptoms can be very rapid and can rival a toothache in the degree of pain.

The trench mouth designation came from the soldiers in World War I fighting in the trenches. They had all the factors that pre-dispose people to this infection; Lack of sleep, stress, poor diet and lack of oral hygiene. This allows bacteria in the mouth that are normally kept in check by the immune system to take over.

Today, we see most of these cases in students, especially college students, around exam time. High stress, poor diet, no sleep, etc. Just like those soldiers in the trenches. The stress factor is a major one since it has been shown that stress can negatively impact the immune system.

The treatment is rather simple. Early treatment with antibiotic will reverse the disease almost at once. (If left too long the gums may not grow back to normal shape.) Some antibiotic mouthwash will help as well, but will not be sufficient without the systemic antibiotic. And brushing and flossing need to be stepped up to a very high level. All these need to be followed by a thorough cleaning by the dentist or hygienist, and regular follow-up care. Most important, the disease is preventable by staying in good shape dentally and physically.

Acute gingivitis can be seen in any age group and can be very serious in older patients who have more advanced chronic gum disease. In this population, the damage to the already compromised gums can be more severe. The factors causing the acute infection and the cures are the same. Quick diagnosis and treatment is essential.

The treatment for ANUG is not effective in cases of chronic disease. Antibiotics are not indicated for chronic periodontitis which requires more professional care along with long term increased oral hygiene procedures.

This article was published on 09-08-2023 in The Altamont Enterprise.