What is Trench Mouth?

Trench Mouth

Last Updated on September 26, 2022 by Dr Gustavo Assatourians DDS

Trench Mouth

Trench mouth is an acute infection of gums, which means it can be triggered quickly and can cause serious damage to your gums and teeth.

What is Trench Mouth?

Trench mouth, also known as Acute Necrotizing Ulcerative Gingivitis (ANUG), is a type of painful gum disease caused by gram-negative bacteria known as spirochetes. It is commonly associated with an underlying or pre-existing minor gingivitis in individuals with poor oral hygiene. Trench mouth is clinically presented by gum bleeding, swelling, pain followed by ulceration between teeth and gum tissues.

What causes a trench mouth?

This condition results from infection of gums by excessive harmful bacteria. If left untreated, it can get worse. The possible causes and risk factors for trench mouth include:

  1. Poor oral hygiene
  2. Stress
  3. Mouth, throat or teeth infection
  4. Poor nutrition
  5. Smoking
  6. Diabetes
  7. Pre-existing gingivitis
  8. Weakened immune system


Trench mouth is a severe acute form of gum disease, characterized by rapid deterioration of gum tissues and swift progression of infection. Major symptoms include:

  • Bad breath
  • Ulcers- crater like sores between your teeth and gums
  • Trench mouth tongue
  • Fever
  • Red and swollen gums
  • Gums that bleed on slightest touch
  • Foul taste in mouth
  • Yellow-white or grey membrane covering the ulcerated papillae
  • Swollen lymph nodes around head, neck, or jaw
  • Fatigue

Trench Mouth

How common is it?

Trench mouth got its name because it was commonly found among the soldiers during the world war-II, due to unhealthy living conditions. These days trench mouth has become relatively rare, affecting about 0.5% to 1% of the population. The increased incidence of trench mouth has been found in individuals with weakened immune system, or particularly those with immune system diseases like HIV. It is more commonly found in populations with poor living and oral hygiene conditions.

Methods to diagnose:

The diagnosis of trench mouth starts with

  • Medical history, including diet and overall habits
  • Investigation for the presence of any immune weakening health diseases
  • Dental history, with special focus on pain symptoms and pre-existing gingivitis
  • Checking for any swollen glands in the head and neck area
  • Checking oral cavity for any signs of infection and swelling
  • Investigations to check for presence of any abnormal amounts of gram negative bacteria to cause trench mouth.

Management and Treatment:

There are four stages in the management of trench mouth:

Stage 1: control progression of disease, and relieve the symptoms of discomfort and pain. It includes

  • Removal of dead or affected tissues from diseased areas using ultrasonic instruments or chemical agents
  • Use of antibiotics for treatment fever or swollen glands due to bacterial infections
  • Use of pain-killers

Stage 2: treatment of pre-existing conditions such as gingivitis

  • Professional cleaning of teeth and gums, scaling or root planning of teeth
  • Instructions and guidelines for the patients to maintain good nutrition, fluid intake, quit habits and good oral hygiene.
  • Use of antibacterial mouthwash as prescribed by your dentist

Stage 3: surgical procedures

  • This stage involves gum surgery to fill craters between the teeth.

Stage 4: maintenance and support

  • It involves long-term monitoring with good oral hygiene and regular check-ups.


If left untreated, trench mouth can lead to rapid destruction of gum tissues, spreading to other tissues such as cheeks, lips or bones of the jaw.

Gum surgery is important to treat craters, if not addressed properly on time could lead to loss of tooth.

Some affected areas may not respond properly to treatment or may revert back after treatment, increasing the chances of tooth loss. Some of the common causes of treatment failure include:

  •  Failure to remove the root cause of the disease
  •  Incomplete removal of the infected tissues
  • Wrong or delayed diagnosis
  • Patient not following the proper directions or not taking the prescribed medications properly
  • Presence of underlying medical issues.

Ways to prevent:

At Channel Island Family Dental office, our dentists often educate our patients about the benefits of regular brushing and flossing. Trench mouth can easily prevented by maintaining a good oral hygiene with regular check-ups for any signs and symptoms of gingivitis.

It is also important to maintain a good general health by resolving stress, getting a good sleep, eating good nutritious food and quitting bad habits such as smoking to build a strong immune system ti fight various infections.


If you have any questions about this or other topics, contact us at  Channel Island Family Dental, as well as on our Facebook page. At Channel Island Family Dental, we are always attentive to your needs to make a timely diagnosis. In addition, our dentists in Oxnard, Santa Paula, Newbury Park  Ventura, and  Port Hueneme will guide you to the best treatment to give you back your best smile.

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