Gingivitis and Acute Necrotizing Ulcerative Gingivitis: (Trench Mouth)

Presentation

With mild gingivitis, the patient’s gums bleed easily and become red and swollen with increased sensitivity. As symptoms worsen, the gums begin to recede and take on a beefy red, inflamed color.

Further progression leads to the most severe periodontal infection, trench mouth, or acute necrotizing ulcerative gingivitis (ANUG).

The patient complains of generalized severe pain of the gums, often with a foul taste or fetid odor (halitosis). The gingiva will appear edematous and red, with a grayish necrotic membrane between the teeth. The gums bleed spontaneously or on gentle touch, and there is loss of gingival tissue, especially the interdental papillae. The teeth will eventually become loose, and the patient may become febrile and show signs of systemic infection with generalized weakness.