World War I is most notable not only for the scope of the war but also for technological developments in weaponry. Unfortunately for the soldiers, another notable condition garnered its name from their suffering: trench mouth.

What is trench mouth?

Trench mouth – also known as acute necrotizing ulcerative gingivitis or ANUG – has been documented since the 4th century BC. This infection of the gums is marked by its rapid progression that can lead to the death of gum tissue and, ultimately, the loss of teeth. The battlefields of World War 1 clearly showed the causes of trench mouth. Poor oral hygiene combined with stress and poor diet can lead to severe gum infection.

Acute necrotizing ulcerative gingivitis is not common, affecting no more than 1% of people in the U.S. Young adults between the ages of 15 and 35 are most likely to develop ANUG. This age group is frequently under stress as they enter adulthood, not paying much attention to their diet or oral hygiene. Smoking can also increase the risk of developing trench mouth, and many young adults may try nicotine at this age.

Patients with compromised immune systems (i.e., those with HIV) are more at risk for developing infections of any kind, as are people who are diagnosed with Type 1 and Type 2 diabetes.

What are trench mouth symptoms?

When it first appears, trench mouth is characterized by a rapid deterioration of gum tissue and a swift progression of infection. Major symptoms include:

  • Foul breath: Some doctors use this as their main diagnostic tool
  • Ulcers: The tips of the gums between teeth develop ulcers that resemble craters
  • Trench mouth tongue: This is a sore and swollen tongue that can indicate the beginning stages of trench mouth
  • Fever
  • Red and swollen gums
  • Gums that bleed at the slightest touch
  • Gums with a grayish film: This occurs as gum tissue breaks down and begins to die (necrotizes)
  • Foul taste in the mouth
  • Swollen lymph nodes: This indicates an advanced state of trench mouth

In general, those suffering from trench mouth will also feel fatigue and general malaise, two symptoms that are common when the body fights infection.

Diagnosing trench mouth

Diagnosis starts with a complete medical history that includes current stressors, family history, diet, and oral hygiene practices.

Your doctor may also test for the presence of fusiform bacteria, Prevotella intermedia, and spirochetes, three forms of bacteria that may be present with trench mouth. Other diagnostics include a physical examination for the above symptoms of infection, as well as evidence of pasty saliva that can occur with this condition.

Is trench mouth contagious?

As with most infections, acute necrotizing ulcerative gingivitis is not contagious.

Symptoms can resemble other contagious oral conditions, but trench mouth is not able to be transmitted to another person in any way.

How long does trench mouth last?

The duration of trench mouth depends on the patient’s overall health and what steps they take to treat the disease.

Your dentist will evaluate you and determine the appropriate length of treatment for fastest healing times.

What are common trench mouth treatments?

Obviously, prevention is the best option. Trench mouth is extremely painful and can lead to other serious conditions, so stopping it before it starts is the first step. Practicing good oral hygiene, including brushing your teeth twice a day, flossing at least once, and rinsing once daily with an alcohol-free mouthwash is a good start.

Moderate your stress with meditation practice, yoga, daily walks, or other exercise. This can help remove the psychological risk factors for trench mouth, as can getting enough sleep.

A healthy diet that limits sugar and processed foods, plus quitting smoking and limiting alcohol intake are the final preventative steps to take.

If you do contract trench mouth, expect four treatment steps.

1. Limit or stop progression and treat pain

Severe oral infections will continue to progress unchecked if this step isn’t taken. Your dentist may prescribe oral antibiotics (e.g., amoxicillin) to stop the disease from progressing. Painful gums can usually be treated with over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen.

Once gums are less painful, your dentist will remove any dead gum tissues with either chemical agents or an ultrasonic instrument.