Acute Necrotising Ulcerative Gingivitis (ANUG)
Acute Necrotising Ulcerative Gingivitis (ANUG)
Also know as Vincent’s Infection or Trench Mouth, is a painful bacterial infection and ulceration of the gums.
What to look for
Symptoms often begin suddenly. The gums are red and puffy, very painful and bleed in response to any pressure. Crater like ulcers are seen along the margins of the gums next to one or more teeth.
The mouth is very sore and because of this the patient may not wish to eat.
The ulcers may have a white covering, bleed easily or be oozing pus.
The patient’s breath has a characteristic foul smell.
Sometimes the patient feels generally unwell and may have a temperature.
Treatment
Carefully apply a little 5% chromic acid or similar strong antiseptic on a very small piece of cotton wool to the ulcers. Do this once a day for outpatients, being careful not to allow medicine to touch anywhere else in the mouth or on the skin because it may burn. Tell the patient to keep the mouth clean. If it is too sore to use a brush, cotton wool or even a damp cloth may be used to wash the teeth.
Rinsing the mouth with warm salt water after meals is also helpful and antibiotics would be recommended for most cases – Metronidazole may be prescribed (See Teeth Relief manual page 53).
As soon as possible correct brushing with a toothbrush should be started. It is also important to ensure that the patient is having a good diet especially in child cases.
Good oral hygiene is vital to the treatment of AUG.
Hydrogen peroxide, used to rinse or irrigate the gums, is often recommended as is Chlorhexidine or salt water rinsing (see p.53 Teeth Relief manual).
Metronidazole may also be prescribed (see p.52 Teeth Relief manual).
Risk factors
- Poor oral hygiene
- Poor nutrition
- Throat, tooth or mouth infections
- Smoking
- Emotional stress
- HIV/AIDS
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