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Acute Necrotizing Ulcerative Gingivitis

(ANUG; Trench Mouth; Vincent's Stomatitis)

by Diana Kohnle

Definition

Acute necrotizing ulcerative gingivitis (ANUG) is a serious infection of the gums that causes ulcers, swelling, and dead tissues in the mouth. Although it is a very painful condition, it can be healed with treatment.

Causes

Acute necrotizing ulcerative gingivitis is typically caused by excess bacteria in the mouth. Too much bacteria can form in the mouth from smoking , stress, lack of dental care, a virus, and poor diet.

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition. Risk factors for ANUG include:

Lack of dental care

Poor dental hygiene

Poor diet

Vitamin deficiencies

Infections in the throat, teeth, or mouth

Compromised immune system

Smoking

Stress

Age: 35 years or younger

Symptoms

If you experience any of these symptoms, do not assume it is due to acute necrotizing ulcerative gingivitis. These symptoms may be caused by other health conditions. If you experience any one of them, see your dentist.

Pain in the gums

Gums that bleed easily

Bad taste in mouth, extremely bad breath

Red and swollen gums

Gray residue on the gums

Large ulcers or loss of gum tissue in between teeth

Fever

Swollen lymph nodes

Red and Swollen Gums

Diagnosis

Your dentist will ask about your symptoms and medical history. A dental exam will be done to look for:

Inflammation of the gums

Destroyed gum tissue

Crater-like ulcers in the gums that may contain plaque and debris from food

Dental x-rays

Facial x-rays

Dental X-ray

Treatment

Talk with your dentist about the best treatment plan for you. Treatment options include:

Antibiotics to clear up the infection

Dental surgery

Improved diet

Regular dental cleanings

Changes in diet

Prevention

To help reduce your chances of getting ANUG, take the following steps:

Maintain a balanced, nutritional diet.

Take proper care of teeth and gums.

See your dentist regularly.

RESOURCES:

American Academy of Periodontology

http://www.perio.org/

American Dental Association

http://www.ada.org/

CANADIAN RESOURCES:

Canadian Dental Association

http://www.cda-adc.ca/

Canadian Dental Hygienists Association

http://www.cdha.ca/

References:

Acute necrotizing ulcerative gingivitis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed . Updated November 30, 2009. Accessed October 30, 2012.

Contreras A, Falkler WA Jr, Enwonwu CO, et al. Herman herpesviridae in acute necrotizing ulcerative gingivitis in children in Nigeria. Oral Microbiol Immunol. 1997;12:259-265.

Schreiner C, Quinn FB. Stomatitis. University of Texas Medical Branch website. Available at: http://www.utmb.edu/otoref/grnds/stomatitis.htm . Published November 29, 1995. Accessed October 30, 2012.

Last reviewed October 2012 by Michael Woods, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.