Trench Mouth

Trench mouth (Vincent's infection, acute necrotizing ulcerative gingivitis) is a painful, noncontagious infection of the gums, causing pain, fever, and sometimes fatigue.

The term trench mouth comes from World War I, when many soldiers in the trenches developed the infection. Trench mouth is now rare, although minor infection probably occurs relatively commonly. The severe form usually affects only people with an impaired immune system.

The infection is caused by an abnormal overgrowth of the bacteria that normally exist harmlessly in the mouth. Poor oral hygiene usually contributes to the development of trench mouth, as does physical or emotional stress, poor diet, and lack of sleep. The infection occurs most often in people who have gingivitis and experience a stressful event. Trench mouth is far more common among smokers than nonsmokers.

Usually, trench mouth begins abruptly with painful gums, an uneasy feeling, and fatigue. Foul breath also develops. The tips of the gums between the teeth erode and become covered with a gray layer of dead tissue. The gums bleed easily, and eating and swallowing cause pain. Often, the lymph nodes under the jaw swell, and a mild fever develops.

Treatment begins with a gentle, thorough cleaning. Rinsing several times a day with a hydrogen peroxide solution (3% hydrogen peroxide mixed half-and-half with water) may be recommended instead of brushing for the first few days because of the sensitivity of the gums. Antibiotics may be given for the first few days as well. The infection responds very well to good oral hygiene (daily brushing and flossing).