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Acute Necrotizing Ulcerative Gingivitis(ANUG; Trench Mouth; Vincents Stomatitis)
Definition

Acute necrotizing ulcerative gingivitis (ANUG) is a serious infection of the gums that causes ulcers, swelling, and dead tissues in the mouth.

Causes

Acute necrotizing ulcerative gingivitis is typically caused by excess bacteria in the mouth.

Risk Factors

ANUG most often impacts people who are 35 years of age and younger. Factors that may increase the risk of ANUG include excess bacteria in the mouth due to:

  • Lack of dental care
  • Poor dental hygiene
  • Poor diet
  • Vitamin deficiencies
  • Infections in the throat, teeth, or mouth
  • A weak immune system
  • Smoking
  • Stress
Symptoms

Symptoms may include:

  • Pain in the gums
  • Gums that bleed easily
  • Bad taste in the mouth; extremely bad breath
  • Red and swollen gums
  • Gray residue on the gums
  • Large ulcers or loss of gum tissue in between teeth
  • Fever
  • Discomfort
  • Swollen lymph nodes

Red and Swollen Gums

Gingivitis

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Diagnosis

You will be asked about your symptoms and medical history. A dental exam will be done.

Images may be taken of your teeth and face. This can be done with x-rays.

Dental X-ray

Jaw x-ray teeth

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Treatment

Although ANUG is a painful condition, it can be treated. Treatment may include:

  • Antibacterial mouthwash
  • Pain control with nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen
  • Dental surgery
  • Regular dental cleanings
  • Antibiotics to treat infection
  • Changes in diet
Prevention

To help reduce your chances of ANUG:

  • Take proper care of teeth and gums.
  • See your dentist regularly.
  • Eat a balanced diet.

RESOURCES:

American Academy of Periodontology
http://www.perio.org

Mouth Healthy—American Dental Association
http://www.mouthhealthy.org

CANADIAN RESOURCES:

Canadian Dental Association
http://www.cda-adc.ca

Dental Hygiene Canada
http://www.dentalhygienecanada.ca

References:

Acute Necrotizing Ulcerative Gingivitis. Merch Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/dental-disorders/periodontal-disorders/acute-necrotizing-ulcerative-gingivitis-anug. Updated June 2017. Accessed August 21, 2017.

Atout RN, Todescan, S, J Can Dent Assoc 2013;79:d46. Available at: http://www.jcda.ca/article/d46. Accessed September 18, 2017.



Last reviewed September 2017 by EBSCO Medical Review Board Michael Woods, MD, FAAP

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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