ANUG
In today’s busy world, many people are under a lot of stress, some even have acute anxiety. Under these conditions there is a predisposition for developing an oral condition called Acute Necrotizing Ulcerative Gingivitis (ANUG), more commonly known as “trench mouth” for its common occurrence among soldiers in the trenches during World War I.
ANUG is often associated with an underlying or pre-existing minor gingivitis (“gingiva” – gum; “itis” – inflammation) in individuals who may have not been taking good care of their oral health, brushing, flossing and getting regular dental checkups and cleanings. ANUG is also commonly associated with smoking, which seems to dry the mouth and change the bacterial flora — the normal bacteria that reside in the mouth, and is even necessary for health. Poor nutrition is another predisposing factor to infection. Thus when the conditions are just right (or just wrong), ANUG can take hold.
ANUG, Acute Necrotizing Ulcerative Gingivitis. Here is a breakdown of the condition:
Acute – painful and appearing quite suddenly;
Necrotizing – refers to dead tissue which looks as sloughing and greying looking gums;
Ulcerative – the gum tissue, mainly the papillae (little triangular peaks of gum tissue between the teeth) actually become ulcerated and yellowish;
Gingivitis – in this case the gum tissues become acute, red, and bleed spontaneously. Some symptoms may also include very bad breath and taste.
What Should You Do?
Don’t be alarmed, this is very treatable and completely reversible if caught early. The condition is associated with a bacterial infection by organisms known as “fusiforms” and “spirochetes,” which respond well to particular local treatment and antibiotics.
Most importantly, call your dentist to confirm that this is indeed what you have. Although ANUG is quite easy to diagnose by a dentist, there are other conditions that it could be confused with, which range from viral infection to localized malignancy (cancer).
Treatment is aimed first at relieving the symptoms and then the underlying conditions that led to it. Aspirin and ibuprofen (ADVIL) are ideal for this situation, in addition to prescription antibiotics, which must be taken orally to work their way through the body. Taken together with chlorhexidine, a prescription antibacterial mouth rinse, and saline (mild saltwater) rinses, symptoms should subside within 24 to 48 hours.
It is also important to treat the underlying conditions that led to the ANUG in the first place. Good oral hygiene including brushing and flossing, together with a cleaning by your Hygienist, will allow the gums to heal. Quitting smoking, getting rest and maintaining good nutrition are also very important.