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Trench mouth

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Contents of this page:

Illustrations

Dental anatomy
Dental anatomy

Alternative names    Return to top

Vincent's stomatitis; Acute necrotizing ulcerative gingivitis

Definition    Return to top

Trench mouth is a painful bacterial infection and ulceration of the gums (gingiva).

Causes, incidence, and risk factors    Return to top

Trench mouth is a painful form of gingivitis (gum inflammation). The term "trench mouth" comes from World War I, when the disorder was common among soldiers.

The mouth normally contains a balance of different microorganisms. Trench mouth occurs when there is an overabundance of normal mouth bacteria resulting in infection of the gums, which develop painful ulcers. Viruses may be involved in allowing the bacteria to overgrow.

Risks include the following:

This disorder is rare. When it does occur, trench mouth most often affects adults younger than 35.

Symptoms    Return to top

Note: Symptoms often begin suddenly.

Signs and tests    Return to top

The health care provider will examine your mouth to look for signs of trench mouth:

There may be a gray film caused by decomposed gum tissue. Occasionally, fever may be present or lymph nodes of the head and neck may be swollen.

Dental X-rays or facial X-rays may be performed to determine the extent of infection and tissue destruction.

This disease may also alter the results of a throat swab culture.

Treatment    Return to top

The goals of treatment are cure of the infection and relief of symptoms. Your health care provider may prescribe antibiotics if you have a fever.

Good oral hygiene is vital to the treatment of trench mouth. Thorough tooth brushing and flossing must be performed as often as possible, at least twice a day and preferably after each meal and at bedtime. Salt water rinses (one-half teaspoon of salt in one cup of water) may be soothing to sore gums. Hydrogen peroxide, used to rinse or irrigate the gums, is often recommended to remove decayed gum tissue.

Over-the-counter pain relievers (analgesics) may be used to reduce discomfort. Soothing rinses or coating agents may reduce pain, especially prior to eating. Viscous lidocaine may be used for severe pain.

You may be asked to visit a dentist or dental hygienist to have your teeth professionally cleaned, with thorough plaque removal, once your gums feel less tender. Dental cleaning and examination may be recommended on a regular, frequent basis until the disorder is cleared.

You may be given instructions regarding methods to stop smoking, reduce stress, mantain good oral hygiene, or other steps to prevent this condition from recurring. You may also be advised on how to maintain good general health, including proper nutrition and rest balanced with exercise.

Irritants must be avoided, including smoking and hot or spicy foods.

Expectations (prognosis)    Return to top

The infection usually responds to treatment. The disorder can be quite painful until it is treated. If trench mouth is untreated or treatment is delayed, the infection can spread to the cheeks, lips, or jawbone and destroy these tissues.

Complications    Return to top

Calling your health care provider    Return to top

Call the dentist if symptoms of trench mouth occur, or if fever or other new symptoms develop in a person with this disorder.

Prevention    Return to top

Good oral hygiene is important to prevent trench mouth, including thorough tooth brushing and flossing and regular professional dental cleaning and examination. Good nutrition and good general health also help to prevent the disorder. Other preventive measures include stopping smoking and learning ways to cope with stress.

Update Date: 12/25/2002

Updated by: Jonathan Fanaroff, M.D., Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, OH. Review provided by VeriMed Healthcare Network.

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