Trench mouth

Trench mouth

Definition  :

Trench mouth is a severe form of gingivitis that causes painful, infected, bleeding gums and ulcerations. Although trench mouth is rare today in developed nations, it's common in developing countries that have poor nutrition and poor living conditions.

Trench mouth is formally known as Vincent's stomatitis, acute necrotizing ulcerative gingivitis (ANUG) and necrotizing ulcerative gingivitis (NUG). Trench mouth earned its nickname because of its prevalence among soldiers who were stuck in the trenches during World War I without the means to take care of their teeth properly.

Symptoms:

Signs and symptoms of trench mouth can include:

• Severe gum pain
• Bleeding from gums when they're pressed even slightly
• Red or swollen gums
• Pain when eating or swallowing
• A gray film on your gums
• Crater-like sores (ulcers) between your teeth and on your gums
• A foul taste in your mouth
• Bad breath
• Fever
• Swollen lymph nodes around your head, neck or jaw

When to see a dentist
Trench mouth symptoms can develop quickly. See your dentist immediately if you develop any symptoms. Often these may be symptoms of a gum problem other than trench mouth, such as gingivitis or periodontitis. But all forms of gum disease can be serious, and most tend to get worse without treatment. The sooner you seek care, the better your chance of returning your gums to a healthy state and preventing loss of teeth and destruction of bone or other tissue.

Causes:

Your mouth naturally contains microorganisms, including fungi, viruses and bacteria. In trench mouth, though, harmful bacteria grow out of control, causing infection of your gums. This infection can damage or destroy the delicate gum tissue (gingiva) that surrounds and supports your teeth. Large ulcers, often filled with bacteria, food debris and decaying tissue, may form on your gums, leading to severe pain, bad breath and a foul taste in your mouth.

Precisely how these bacteria destroy gum tissue isn't known. But it's thought that enzymes and toxins produced by the bacteria play a role.

Complications:
 
Complications and problems that trench mouth may cause or be associated with include:

• Trouble swallowing
• Trouble eating
• Pain when brushing teeth
• Destruction of gum tissue
• Tooth loss
• Progression into advanced oral diseases that can severely damage bone and gum tissue

Treatments and drugs:

Treatment of trench mouth is generally highly effective, and complete healing often occurs in just a couple of weeks. However, healing may take longer if your immune system is compromised, such as by HIV/AIDS.

Medications
Because trench mouth involves an overgrowth of bacteria, antibiotics are often prescribed to eradicate the bacteria and prevent infection from spreading. You may also need over-the-counter or prescription pain relievers. Getting pain under control is important so that you can eat properly and resume good dental care habits, such as brushing your teeth. Your dentist may also recommend a pain reliever that you can apply directly to your gums (topical anesthetic).

Cleaning your teeth and gums
Treatment also includes a thorough but gentle cleaning of your teeth and gums. Your dentist removes any dead gum tissue (debridement) to help reduce pain. Your mouth may be rinsed with an antiseptic solution. When your gums are less tender, you'll undergo a type of tooth cleaning called scaling and root planing. This procedure removes plaque and tartar from beneath your gumline and smooths any roughened surfaces of your teeth.
Right after cleaning, your gums will be quite tender. Your dentist will probably advise you to rinse your mouth with a hydrogen peroxide mouthwash, salt water or a prescription mouth rinse, in addition to brushing gently with a soft toothbrush. Once your gums begin to heal, brush and floss at least twice a day — preferably after every meal and at bedtime — to prevent future problems.

When surgery is necessary
Although your gums are likely to heal and return to their normal shape with professional cleaning and proper home care, you may need surgery to help repair them if you have extensive damage.