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Pronunciations necrotizing ulcerative gingivitis periodontal periodontitis

Trench mouth (Vincent's infection, acute necrotizing ulcerative gingivitis) is a painful, noncontagious infection of the gums, causing pain, fever, and sometimes fatigue.

• If the normal bacteria in the mouth overgrow, the gums can become infected.
• The gums hurt, and people have extremely bad breath.
• A professional cleaning, sometimes followed by hydrogen peroxide rinses and antibiotics, plus good oral hygiene are effective.

The term trench mouth comes from World War I, when many soldiers in the trenches developed the infection. Trench mouth is now rare, although minor gum infections probably occur relatively commonly. The severe form usually affects only people with an impaired immune system.

The infection is caused by an abnormal overgrowth of the bacteria that normally exist harmlessly in the mouth. Poor oral hygiene usually contributes to the development of trench mouth, as do physical or emotional stress, poor diet, and lack of sleep. The infection occurs most often in people who have gingivitis and experience a stressful event. Trench mouth is far more common among smokers than among nonsmokers.

Usually, trench mouth begins abruptly with painful gums, an uneasy feeling, and fatigue. The breath smells extremely foul. The tips of the gums between the teeth erode and become covered with a gray layer of dead tissue. The gums bleed easily, and eating and swallowing cause pain. Often, the lymph nodes under the jaw swell, and a mild fever develops.

Diagnosis and Treatment

Because the breath smells so foul, doctors sometimes suspect the diagnosis immediately, as soon as they come into contact with affected people.

Treatment begins with a gentle, thorough professional cleaning. Rinsing several times a day with a hydrogen peroxide solution (ordinary drugstore hydrogen peroxide mixed half-and-half with water) may be recommended instead of brushing for the first few days because of the sensitivity of the gums. Antibiotics (such as amoxicillin Some Trade Names
AMOXILTRIMOX
, erythromycin Some Trade Names
E-MYCINERYTHROCIN
, or tetracycline Some Trade Names
SUMYCIN
) may be given as well. The infection responds very well to good oral hygiene (daily brushing and flossing).

Last full review/revision October 2008 by James T. Ubertalli, DMD