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

Alternative Names

Vincent's stomatitis; Acute necrotizing ulcerative gingivitis; Stomatitis

Causes, incidence, and risk factors

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 and inflammation of the gums, which develop painful ulcers . Viruses may be involved in allowing the bacteria to overgrow. Risks include poor oral hygiene , poor nutrition, throat, tooth or mouth infections, smoking , and emotional stress . The disorder is rare. It usually affects young adults between 15 and 35 years old.

Signs and tests

Examination of the mouth shows inflamed gums with destruction of gum tissue around the teeth. Crater-like ulcers fill with plaque and food debris. 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

The goals of treatment are cure of the infection and relief of symptoms. Antibiotics may be given if there is 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. Scaling and polishing the teeth (professional cleaning and plaque removal by the dentist or dental hygienist using a variety of tools) is recommended once the gums become less tender. Dental cleaning and examination may be recommended on a regular, frequent basis until the disorder is cleared. Instruction may be needed on oral hygiene, methods to stop smoking , stress reduction, etc. Good general health should be maintained. This includes proper nutrition and rest balanced with exercise . Irritants must be avoided, including smoking and hot or spicy foods.

Expectations (prognosis)

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

Calling your health care provider

Prevention

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 .