What is Necrotizing Ulcerative Gingivitis or Trench Mouth?

Necrotizing ulcerative gingivitis is a fairly common dental health issue. This disease of the gums has numerous other names. Dentists call Necrotizing Ulcerative Gingivitis (NUG) also as Trench Mouth, Vincent's Disease or Vincent's Infection. The origin of the name Trench Mouth comes from the time of World War I. During the World War I, soldiers that were spending most of their time in trenches got this disease and thus the other name for NUG - Trench Mouth. The other name for NUG, Vincent's Disease, was derived from the name of famous French physician in the World War I - H. Vincent.

Necrotizing ulcerative gingivitis or trench mouth in a nutshell, is a non-contagious bacterial infection of the gums with sudden onset. Some of the main features of Necrotizing ulcerative gingivitis or trench mouth include painful and bleeding gums, and gum ulcers. One interesting thing about necrotizing ulcerative gingivitis is that it often occurs during the times of severe stress, particularly in teens and young adults. However, Necrotizing ulcerative gingivitis or trench mouth most commonly affects people who do not pay a lot of attention to their oral hygiene and who have already had gingivitis. Necrotizing ulcerative gingivitis or trench mouth also affects smokers.

What is Necrotizing Ulcerative Gingivitis or Trench Mouth?

Let us explain what all three words in the complex word Necrotizing Ulcerative Gingivitis mean regarding this gum disease:

  • Necrotizing - refers to death of tissue
  • Ulcerative - the gum tissue, most often the little triangular peaks between the teeth become yellowish and ulcerated
  • Gingivitis - when the gum tissue becomes swollen, red, and bleeds

Causes of Necrotizing Ulcerative Gingivitis or Trench Mouth

Normally, your mouth contains a certain amount of bacteria that is managed by immune system. However, if those mouth bacteria start to overload in your mouth, you will most probably get a gum infection that will result in Necrotizing ulcerative gingivitis or trench mouth. Nowadays, necrotizing ulcerative gingivitis is very rare because of the awareness of good oral hygiene. The three main bacteria that cause Necrotizing ulcerative gingivitis or trench mouth are:

  • P. intermedia
  • Fusobacterium
  • Treponema

Necrotizing ulcerative gingivitis or trench mouth particularly develops in people who barely practice proper oral hygiene and in people who do not practice it at all. Necrotizing Ulcerative Gingivitis is often seen in people whose immune system was compromised by HIV/AIDS. That is why necrotizing ulcerative gingivitis has been described as an opportunistic infection.

Necrotizing ulcerative gingivitis or trench mouth can also be caused by an excessive stress. However, that usually happens when there is some underlying dental health issue.

Symptoms of Necrotizing Ulcerative Gingivitis or Trench Mouth

The symptoms of Necrotizing ulcerative gingivitis or trench mouth begin all of sudden. Usually, the primary symptom of necrotizing ulcerative gingivitis is bad breath. In the early stages of Necrotizing ulcerative gingivitis or trench mouth, patients complain that they had bad breath and that they had felt tightness around their teeth. Some necrotizing ulcerative gingivitis patients have reported that they had foul taste in their mouth and a fever as the first symptoms of their necrotizing ulcerative gingivitis.

However, only an experienced dentist can diagnose for certain if the patient suffers from Necrotizing ulcerative gingivitis or trench mouth. There are three main symptoms according to which a dentist gives necrotizing ulcerative gingivitis diagnosis. Those symptoms include:

  • Extreme Gingival Pain
  • Profuse Bleeding from the Gums that Requires Little to No Provocation
  • Ulcerated Interdental Papillae with Necrotic Slough

Other signs and symptoms of Necrotizing ulcerative gingivitis or trench mouth include:

Diagnosis of Necrotizing Ulcerative Gingivitis or Trench Mouth

The diagnosis of Necrotizing ulcerative gingivitis or trench mouth is usually done in a clinical environment. An experienced dentist can recognize Necrotizing ulcerative gingivitis or trench mouth while he/she inspects your gums. However, if your dentist is unsure whether you have Trench Mouth or not, he/she will order an X-ray of your teeth to be certain you have NUG or not. The X-ray scan of your teeth that you will perform will show did the necrotizing ulcerative gingivitis infection spread to the bones beneath your gums.

Clinical dentists may order smear for leukocytes and fusospirochaetal bacteria to diagnose you with necrotizing ulcerative gingivitis. They order these tests to differentiate necrotizing ulcerative gingivitis from Herpetic Stomatitis or Leukemia. You may also be told to get tested for HIV/AIDS if you were diagnosed with Necrotizing ulcerative gingivitis or trench mouth because necrotizing ulcerative gingivitis is an opportunistic infection seen in HIV/AIDS patients.

Treatment for Necrotizing Ulcerative Gingivitis or Trench Mouth

Once Necrotizing ulcerative gingivitis or trench mouth has been diagnosed, it is important to start with the treatment of that gum disease as soon as possible. The treatment of Necrotizing ulcerative gingivitis or trench mouth starts with professional and thorough teeth cleaning that is done over a couple of days. After you are finished with that treatment, you are advised to continue rinsing your mouth at home several times per day with a hydrogen peroxide solution or chlorhexidine.

If you experience severe pain associated with your Necrotizing ulcerative gingivitis or trench mouth, your dentist will prescribe you medications that will relieve your pain. If there is systemic involvement to your necrotizing ulcerative gingivitis, your dentist will prescribe you an oral antibiotic, such as metronidazole. Trench Mouth patients who are smokers are advised to quit smoking during their treatment of necrotizing ulcerative gingivitis.

Prevention of Necrotizing Ulcerative Gingivitis or Trench Mouth

There is not much presence of Necrotizing ulcerative gingivitis or trench mouth in the world but it is however one of the most common gum diseases. The most important preventive measure against developing Necrotizing ulcerative gingivitis or Trench Mouth is good oral hygiene. Paying a visit to dentist every six months is also a good way to prevent necrotizing ulcerative gingivitis.

Other preventive measures include:

  • Good overall health.
  • Proper nutrition.
  • Learning how to cope with stress.
  • Regular professional dental cleanings.
  • Quitting smoking.

Chronic stress is also a common cause of necrotizing ulcerative gingivitis and it is very important to learn how to manage chronic stress before it leads to consequences such as Necrotizing ulcerative gingivitis or trench mouth.

Speaking of good oral hygiene, which is a great preventive measure against necrotizing ulcerative gingivitis, most of the people think that it only involves brushing teeth and rinsing your mouth. However, good oral hygiene is far more than that. The proper oral hygiene includes:

  • Brushing teeth thoroughly at least twice a day
  • Flossing every day
  • Eating a balanced diet that lacks snacks between the meals
  • Using toothpaste and other dental health products that contain fluoride
  • Rinsing your mouth with a mouth rinse product that contains fluoride
  • Ensuring that your children under the age of 12 take fluoride supplements or drink fluoridated water if you live in a non-fluoridated area.

If you do not know what the proper way to brush your teeth is, we will explain it to you, step by step:

  • Tilt your toothbrush at a 45 degrees angle against your gum line and either sweep or roll the toothbrush you use away from the gum line.
  • Gently brush each of your teeth's outside, inside, and chewing surface. Perform this with short and rapid back-and-forth strokes.
  • Gently brush your tongue. Some toothbrushes have a specialized tongue cleaner on their back so you can brush your tongue with it.
  • Rinse your mouth thoroughly, leaving no traces of toothpaste in your mouth.

Prognosis/Outlook for Necrotizing Ulcerative Gingivitis or Trench Mouth

As with any existent disease in the world, the sooner you are diagnosed with Necrotizing ulcerative gingivitis or trench mouth, the better your dental health prognosis/ outlook is. It is important to mention that Necrotizing ulcerative gingivitis or trench mouth is not a malignant disease. However, if it is left untreated, it can increase a person's risk for oral cancer.

The untreated Necrotizing ulcerative gingivitis or trench mouth may be devastating for overall health, particularly for the oral health. Untreated cases of Necrotizing ulcerative gingivitis or trench mouth lead to the rapid destruction of the gums, cementum, periodontal ligament, and alveolar bone proper. Also, untreated Necrotizing ulcerative gingivitis or trench mouth can spread to the surrounding tissues in the lips, cheeks, and the jaw bones.

Lifestyle Changes for Necrotizing Ulcerative Gingivitis or Trench Mouth

Necrotizing ulcerative gingivitis is painful. To help yourself cure from Necrotizing ulcerative gingivitis or trench mouth as soon as possible you should:

  • Quit smoking
  • Avoid spicy foods
  • Avoid hot foods
  • Avoid drinking beverages that are carbonated
  • Avoid drinking alcohol
  • Eat a healthy diet

Home Remedies for Necrotizing Ulcerative Gingivitis or Trench Mouth

The best home remedy for treating the painful Necrotizing ulcerative gingivitis or trench mouth is rinsing your mouth with salty water or a mouth rinser that your dentist has prescribed you. Sticking up to this will treat your necrotizing ulcerative gingivitis rapidly and you will smile once again.

Coping with Necrotizing Ulcerative Gingivitis or Trench Mouth

As we have said, Necrotizing ulcerative gingivitis or trench mouth is painful. You will need some kind of support during your necrotizing ulcerative gingivitis treatment. The best coping method you can get while you are being treated for Necrotizing ulcerative gingivitis or trench mouth is the support of your family. If you experience severe pains, get a pet if you cannot stand taking pain medications. It has been scientifically proven that playing with pets relieves one's chronic pains.

Also Read:

Written, Edited or Reviewed By:

, MD, FFARCSI

Last Modified On: July 11, 2017

Pain Assist Inc.

Pramod Kerkar
  Note: Information provided is not a substitute for physician, hospital or any form of medical care. Examination and Investigation is necessary for correct diagnosis.

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