necrotizing ulcerative gingivitis

Acute necrotizing ulcerative gingivitis

Acute necrotizing ulcerative gingivitis (ANUG) is a polymicrobial infection of the gums leading to inflammation, bleeding, deep ulceration and necrotic gum tissue. Symptoms include fever and halitosis.

Terminology

It is also known as "Plaut-Vincent angina", "Vincent's stomatitis", "Vincent's angina", "Vincent's infection", "Acute Ulcerative Gingivitis" or "Trench Mouth."

The common name, Trench Mouth, was probably coined during World War I when many soldiers suffered from the condition. There are a number of other theories to the origin of the name. Vincent's angina was named after French physician Jean Hyacinthe Vincent (1862-1950).

Causes

Causative organisms include anaerobes such as Bacteroides and Fusobacterium as well as spirochetes (Borrelia and Treponema spp.).

The condition is caused by an overpopulation of established oral bacteria due to a number of interacting factors such as poor hygiene, poor diet, smoking, lifestyle and other infections. This condition is now found more commonly in the younger generation.

Treatment

Treatment is by the simple reduction of the bacteria through improved oral cleaning and salt water or hydrogen peroxide-based rinses. Chlorhexidine or metronidazole can also be used in addition. Penicillin is also indicated at 250 mg every 6 to 8 hours. A regular visit to the Hygienist at a dental practice will aid healing, but without preventing the initial cause of the condition, repeated infection will occur.

Prognosis

Untreated, the infection may lead to rapid destruction of the periodontium and can spread, as necrotizing stomatitis, into neighbouring tissues in the cheeks, lips or the bones of the jaw. The condition can occur and be especially dangerous in people with weakened immune systems.

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