by Shen-Li Lee

Created on: October 30, 2009

Trench mouth is an oral disease affecting the gums. It also comes under the name of Vincent's angina, Vincent's stomatitis, Vincent's infection and acute necrotising ulcerative gingivitis (ANUG). The term trench mouth was adopted because it was a common condition among the soldiers in the trenches during World War I where they were unable to take proper care of their teeth and gums. Trench mouth is now an uncommon condition that rarely affects individuals in developed nations. It is mostly associated with developing countries where nutrition and living conditions are poor. It is also observed in people with a deficient immune function.

The bacteria that cause trench mouth are inherent to the mouth. In a normal, healthy individual, these bacteria are usually kept at bay and remain harmless. However, when conditions change (such as in the case of poor oral hygiene, emotional stress, poor diet and lack of sleep), they begin to overgrow and cause problems.

The Symptoms of Trench Mouth

1. Fever - the lymph nodes around the head, neck and jaw usually begin to swell, followed by a mild fever.

2. Bleeding gums - the gums are red and swollen and bleed easily, even when pressed slightly.

3. Ulcers - the tips of the gums between the teeth erode, becoming gray and necrotic. The dead tissue sloughs off and crater-like sores begin to form.

4. Pain - there is severe gum pain and both eating and swallowing can be painful.

5. Fatigue.

6. Halitosis (bad breath) - individuals with trench mouth have very bad breath due to the nature of the bacteria present. They may also experience a foul taste in their mouths.

The Treatment for Trench Mouth

Treatment for trench mouth is fairly simple and straightforward. The bacterial overgrowth is reduced with professional cleaning. Initial cleaning involves gentle cleaning of the teeth and gums and removal of the dead tissues. Once the pain has reduced, professional scaling and root planning of the teeth is required to remove plaque and tartar under the gums.

Proper oral hygiene practices must continue to be carried out at home by the individual. Rinsing with hydrogen peroxide rinses, possibly with the adjunctive use of chlorhexidine or metronidazole, will also help. During the initial few days, this may be the recommended method for cleaning instead of brushing due to the sensitivity of the gums. Antibiotics, such as penicillin, amoxicillin, erythromycin or tetracycline, may also be prescribed to help reduce the infection.

Once the gums begin to heal, proper oral hygiene practices (brushing and flossing) must be carried our regularly to prevent future recurrence. Other factors contributing to trench mouth, such as poor nutrition, stress, etc. must also be eliminated to ensure there is no repeat infection.

Trench mouth is not a common condition these days. Even when it does occur, treatment is usually fairly straight forward and effective. The important part is to ensure there is proper follow-up and maintenance to prevent a recurrence of the disease.

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