What is Acute Gingivitis?

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  • Written By: J.M. Willhite
  • Edited By: Heather Bailey
  • Last Modified Date: 05 October 2019
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Acute gingivitis, also known as acute necrotizing ulcerative gingivitis (ANUG), is a serious, painful condition characterized by the presence of inflammation, gum discoloration, and ulcerated tissue within the oral cavity. Commonly referred to as trench mouth, acute gingivitis originates in the presence of a bacterial imbalance that triggers the development of infection. Treatment for acute gingivitis generally involves the administration of antibiotic medication and professional cleaning. Some cases may necessitate surgery to repair damage caused by severe ulceration and tissue death.

Normally, there is a healthy bacterial presence in the human mouth that works to maintain a delicate balance to aid with digestion and promote immunity. Unchecked bacterial production can disrupt the established bacterial balance and trigger the development of infection, namely gingivitis. In the presence of acute gingivitis, the soft tissues that comprise the gums become ulcerated allowing for debris to accumulate further promoting infection development. Eventually forming larger sores, or ulcers, the affected tissues begin to decay contributing to widespread tissue death.


A diagnosis of acute necrotizing gingivitis is generally confirmed with a visual inspection of the inside of the mouth by an oral surgeon or dentist who is trained to recognize the tell-tale signs of this condition. Following an initial examination, additional diagnostic testing is usually recommended to evaluate the condition of the affected area and assess the degree of damage and infection present. In most cases, X-rays may be taken and a throat culture performed to verify the bacterial presence at the root of the infection.

Acute gingivitis is a condition that must have an ideal environment to thrive, therefore, certain situations and conditions can increase one’s risk for becoming symptomatic. Those who are susceptible to chronic oral infections or possess compromised immunity are considered to possess an increased risk for developing acute gingivitis. Other factors that may contribute to its development include poor oral hygiene, malnutrition, and tobacco use.

Individuals with acute gingivitis often experience a gradual onset of signs and symptoms that progressively worsen without appropriate treatment. The most prominent signs of this condition are gum pain and inflammation. As the pain worsens, the individual may develop bleeding of the gums that occurs with minimal contact or pressure and persistent halitosis, or bad breath. The affected tissues eventually become ulcerated forming sores that fill with food debris and other foreign matter that contribute to the development of infection. With time, the affected gum tissues may become discolored, adopting a gray or darkened appearance that is indicative of necrosis, or tissue death.

Treatment for acute gingivitis is usually multi-faceted in its approach and requires proactive measures by the symptomatic individual. Initial treatment requires the administration of antibiotic medication to eliminate unnecessary bacterial growth, eradicate infection, and stabilize the bacterial balance within the mouth. A professional cleaning is a necessary part of treatment to remove foreign matter and decayed tissue. Severe cases of necrosis may necessitate oral surgery to repair extensive damage to the gums and surrounding tissues.

Individuals are encouraged to use an antiseptic mouth rinse and brush regularly as their gums start the healing process, which generally takes a few weeks. Proactive personal hygiene is essential to eliminating infection and preventing reinfection. After all signs of infection have passed, it is essential that individuals continue to be proactive with their oral hygiene to lessen their risk for future infection.


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