What is Acute Necrotizing Ulcerative Gingivitis?

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  • Written By: J.M. Willhite
  • Edited By: Heather Bailey
  • Last Modified Date: 21 October 2019
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Acute necrotizing ulcerative gingivitis is a bacterial infection that manifests as ulcers and painful inflammation in the mouth. Also known as trench mouth, acute necrotizing ulcerative gingivitis is a relatively rare condition that may be induced by the presence of infection in the oral cavity. Treatment for trench mouth is centered on managing symptoms, eliminating the underlying infection, and preventing infection recurrence.

The mouth naturally contains various bacteria that co-exist and maintain a delicate balance within the oral cavity. When the balance becomes disrupted and too much bacteria is produced, acute necrotizing ulcerative gingivitis develops. The disorder presents by inducing an infection of the gums that manifests as painful ulcers. As a reaction to the presence of infection, the gums become swollen and inflamed.

Individuals who are under extreme emotional stress may develop compromised immunity due to insufficient rest and diet, which leaves them more vulnerable to infection and increased bacterial production within the oral cavity. Those who practice poor oral hygiene or smoke may be more susceptible to developing acute necrotizing ulcerative gingivitis. Anytime there is infection present in the mouth or throat, the risk for bacterial imbalance that can lead to trench mouth may increase.


Symptoms associated with this condition are often acute in nature, developing suddenly. Individuals may initially experience a foul taste in their mouth accompanied by bad breath. Ulcer formation may present with inflammation, bleeding, and craterlike sores. A grayish film may also develop over the affected gums that have begun to decompose. Additional signs may include persistent fever and swelling of the neck and lymph nodes.

Acute necrotizing ulcerative gingivitis is a condition that may be diagnosed through a visual examination. Additional tests such as dental X-rays and a throat culture may be conducted to evaluate the extent of a trench mouth infection. An X-ray may be utilized to evaluate the severity of infection and pervasiveness of damage to the soft tissues and jaw. A throat culture may be used to isolate and determine the bacterial origin of the infection.

Treatment for trench mouth is centered on eliminating the underlying infection and proactive measures to prevent reinfection. Individuals who experience a fever may be prescribed an antibiotic. Over-the-counter analgesics may also be recommended to alleviate pain. The promotion of responsible hygiene forms the basis of the remaining treatment approach.

Good oral hygiene is an essential step toward alleviating acute necrotizing ulcerative gingivitis and preventing its return. Individuals may be instructed to rinse with saltwater to soothe gum discomfort and hydrogen peroxide to remove dying or dead tissue. A professional teeth cleaning may be necessary to remove accumulated plaque, debris, and food particles that may have settled into the ulcerated gum tissue and between the teeth. Regular check-ups and professional cleanings may be necessary until the infection has been completely eliminated.

The prognosis associated with acute necrotizing ulcerative gingivitis is good with prompt and appropriate treatment. If symptoms are ignored, the infection may spread to surrounding areas in the oral cavity, such as the lips or jawbone. Complications associated with trench mouth may include dehydration, tooth loss, and periodontitis. Proper nutrition, responsible oral hygiene and smoking cessation may reduce an individual’s risk for developing acute necrotizing ulcerative gingivitis.


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