Acute necrotizing ulcerative Gingivitis is a progressive painful infection of the gums with ulceration, swelling, and sloughing off of dead tissue from the Mouth and throat due to the spread of infection from the gums. This disease entity has been described as far back as the days of Hippo crates and is known by many synonyms. The disease is also known by other names, including Vincent's stomatitis and ‘Trench mouth’. It derived the name Trench mouth because of its prevalence among soldiers on the front lines during World War I. Although it's less common today, trench mouth still affects thousands of young adults between the ages of 15 and 35. With the advent of antibiotics and with improved nutritional status, the incidence has decreased and even become extinct in developed countries.

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

The mouth normally houses a variety of microorganisms that live in balance with each other. Most of these are beneficial in the breakdown of food tidbits clinging in nooks and corners of the mouth and keep a check on the growth of harmful ones. Some of these like Streptococcus mutans stand out in taking an active role in tooth decay. When the control mechanism on such harmful bacteria goes awry, diseases like Trench mouth result. Initially it involves the inflammation of the gums and eventually leads to their destruction. Viruses may be involved in allowing the bacteria to overgrow. Nutritional deficiencies, poor oral hygiene, tobacco use, smoking, emotional stress and a compromised immune system can all change the environment in your mouth, leading to an overgrowth of harmful bacteria. Doctors don't fully understand how these bacteria destroy Gum tissue, but enzymes and toxins produced by the bacteria appear to play a role.

The first signs of trench mouth — mouth pain and bad breath — usually appear suddenly. The other symptoms are as follows:

Profuse Gum bleeding in response to any pressure or irritation. Gums appear reddened and swollen. Grayish film on the gums. Crater-like ulcers between the Teeth. Foul taste in the mouth. Bad breathe. Punched out lesions on interdental papillae. Mucus membranes covered with grayish necrotic membrane. Fever or swollen lymph nodes in your head and Neck

Your health care provider will examine the mouth to look for signs like:

Inflamed gums. Destruction of Gum tissue around the teeth. Crater-like ulcers filled with plaque and food debris.

There may be a grey 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.

The primary goal of treatment is the cure of infection and relief from symptoms.Treatment depends upon the severity of the condition. Alleviation of pain may require gentle removal of the dead tissue from the mouth. You may be prescribed oral antibiotics in case you have a Fever. Oral rinsing with an antiseptic solution may also be advised. Later you will require undergoing a tooth cleaning procedure to get rid of the plaque and tartar from beneath your gum line. 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. Viscous lidocaine may be used for severe pain. Once your gums begin to heal, you’ll have to maintain good oral hygiene through tooth brushing and flossing as often as possible. It should be done at least twice a day and preferably after each meal and at bedtime. If healing doesn’t occur or in the presence of extensive gum damage then you may require surgical intervention like Bone grafting and guided tissue regeneration.

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

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.

The complications are:

Pain Spread of infection Loss of Teeth Periodontitis Dehydration