Necrotizing ulcerative gingivitis, better known by its nickname trench mouth, is a condition that leads to infected, painful, bleeding gums and ulcers in the mouth.
It is not often seen in the United States and other developed countries, but it appears frequently in developing nations where poor living conditions and poor nutrition are common. The condition got its nickname due to its widespread occurrence among World War I soldiers who were in the trenches without effective means of cleaning their teeth.
Trench mouth happens when a buildup of bacteria is present in the mouth. While our mouths naturally contain several healthy fungi, bacteria, and viruses, poor dental hygiene allows the bad bacteria to grow uncontrolled.
Patients with gingivitis are at higher risk of developing the infection, as are those who have poor nutrition, a weakened immune system, HIV/AIDS, excessive stress, diabetes, other mouth infections, and a smoking habit.
Symptoms of trench mouth are somewhat similar to those of gingivitis. However, they tend to move along more quickly.
Left untreated, the infection can become much worse and cause damage to the gum tissue. This in turn may lead to additional problems such as tooth loss.
Trench mouth is primarily caused by poor oral hygiene. Failure to brush teeth regularly can result in bacteria, which usually exists harmlessly in the mouth, overgrowing and causing an acute infection of the gums.
Usually, trench mouth develops from gingivitis where the gums become inflamed and painful. If the gingivitis remains untreated, the condition can develop into trench mouth.
In some instances, trench mouth occurs in individuals who are particularly run down or stressed. Lack of sleep, physical exhaustion, poor diet and emotional trauma can all trigger trench mouth in individuals who are already suffering from gingivitis.
It is also known that smokers tend to experience trench mouth more often than nonsmokers. This is because smoking causes individuals to have more dental plaque, which can contribute to trench mouth. Plus, smoking affects blood circulation and tends to result in less oxygen being able to reach the gums, which can make it more difficult for inflamed, damaged or infected gums to heal.
Trench mouth can be prevented by practicing good oral hygiene, including regular dental visits. When it does happen, treatment is very effective and will cure the infection within a few weeks. A dentist might prescribe antibiotics and recommend a professional cleaning. Over-the-counter pain relievers can be used to relieve discomfort and swelling.
Continuing to thoroughly brush and floss and rinsing with hydrogen peroxide or warm salt water is beneficial for relieving inflammation and removing dead tissue.
Good oral hygiene practices are vital for preventing trench mouth. Teeth should be brushed twice daily, for two minutes each time, with toothpaste containing fluoride which helps to protect teeth from plaque. Excess toothpaste after brushing should be spat but the mouth should not be rinsed in order for the fluoride to remain on the teeth.
Electric toothbrushes tend to clean teeth more effectively than manual ones. Toothbrushes or brush heads should be changed at least every three months, or whenever they show signs of wear. A medium texture is usually best, but those with gingivitis or gum disease that have inflamed, sore gums may prefer to use a softer toothbrush to avoid damaging the gums.
Flossing is also an important aspect of oral hygiene and should be performed daily, before brushing, to remove particles of food and bacteria from between the teeth.
Those who smoke should consider quitting to reduce their risk of trench mouth and other oral health problems.