Everyone Healthy Library
Acute Necrotizing Ulcerative Gingivitis
Also Known As: Fusospirochetosis; Trench Mouth; Vincents Disease; Vincents Infection
Condition / disease reference page from the Everyone Healthy database.
Connected health information
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Condition overview
Attributes
Commonalityis rare
Linked signs and symptoms
9Each sign/symptom opens its own page and links back to related conditions.
Linked drugs / medications
1Medication information is educational only. A doctor or pharmacist should advise whether any medicine is appropriate.
Treatments, therapies and supportive options
2Grouped by treatment type. These are educational database links, not personal treatment recommendations. Evidence labels are shown only where stored in the EH database.
Alternative medicine
1Linked diagnostic tests and investigations
8These are pulled from both EH diagnostic-test link tables, including the older large test-link table.
Biological and test markers
6This visual map uses existing EH database links to show biological agents and lab markers reported as increased, decreased, or associated with this condition. These are educational relationships only; test results must be interpreted by a qualified clinician because ranges vary by lab, method, age, sex and clinical context.
Often increased
6- Alpha-1 Antintrypsin (AAT)Reference range exampleAdult ( > 16y): 90–215 mg/dLLinked diagnostic tests1Alpha-1 Antitrypsin (AAT) Concentration
- Alpha-1-Globulin (Blood, Serum)Reference range exampleAll: 0.1–0.3 gm/dLLinked diagnostic tests1Protein Electrophoresis (Blood, Serum Protein)
- Alpha-2-Globulin (Blood, Serum)Reference range exampleAll: 0.6–1 gm/dLLinked diagnostic tests1Protein Electrophoresis (Blood, Serum Protein)
- Cerebrospinal Fluid Total ProteinReference range exampleAdult ( > 16y): 15–45 mg/dL; Child (< 10y): 15–70 mg/dLLinked diagnostic tests1Cerebrospinal Fluid Protein Concentration
- Erythrocyte Sedimentation RateReference range exampleAdult ( > 16y), Female: 0–20 mm/Hr; Adult ( > 16y), Male: 0–15 mm/HrLinked diagnostic tests1erythrocyte Sedimentation Rate (ESR)
- White Blood Cell (WBC)Reference range exampleAdult ( > 16y): 4.5–10.5 million/mL; Adult ( > 16y): 3.2–10 million/mLLinked diagnostic tests1White Blood Cell (WBC) Count
Often decreased
0No markers in this group.
Other associated markers
0No markers in this group.
Introduction / full article
Acute Necrotizing Ulcerative Gingivitis
Acute Necrotizing Ulcerative Gingivitis
Acute necrotizing ulcerative gingivitis (also known as trench mouth, due to its prevalence among soldiers in WWI) is a non-contagious, painful infection of the gums.
Causes
The overgrowth of bacteria and subsequent infection of the gums is often caused by:
· Poor oral hygiene;
· Physical and/or emotional stress;
· Sleep deprivation;
· Nutritionally-inadequate diet;
· Smoking; and
· Pre-existing gingivitis.
Disease pathway
The symptoms of trench mouth all stem from an infection of the gums, due to the presence of excessive bacteria in the mouth.
Symptoms and diagnosis
The onset of symptoms associated with trench mouth is quite rapid. These include:
· Painful gums;
· Erosion and necrosis of the gum;
· Extremely foul breath;
· Susceptibility to bleeding from the gums; and
· Difficulty in eating and swallowing.
Diagnosis can generally be made based on the distinctively foul smell of the breath, in conjunction with physical examination.
Treatment
A thorough, professional cleaning, followed by rinsing the mouth with hydrogen peroxide solution several times daily is the usual method of treatment. Antibiotics may also be administered, to treat the infection.
Brushing the patient’s teeth is avoided, as the gums are highly sensitive to abrasion.
Efficacy of Alternative and Other Treatments According to GRADE* Ranking:
Tea Tree Oil [1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11]:
Please note, this management does NOT treat the condition itself. It is proposed only as a weak supportive symptomatic support, and even then, has insufficient evidence to back up this claim at present. WARNING: Tea Tree Oil is not recommended for children, pregnant women or mothers that are breastfeeding.
Recommendation: No recommendation (There is insufficient evidence to support claims that tea tree oil is effective in treating gingivitis)
Grade of Evidence: low quality of evidence
* www.gradeworkinggroup.org
Summary References
Treatments:
1. Ades T, Alteri R, Gansler T, Yeargin P, "Complete Guide to Complimentary & Alternative Cancer Therapies", American Cancer Society, Atlanta USA, 2009
2. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/tea-tree-oil
3. http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-teatreeoil.html
4. http://www.ncbi.nlm.nih.gov/pubmed/18816275
5. http://bastyrcenter.org/content/view/972/&page=
6. http://jac.oxfordjournals.org/cgi/content/full/62/4/769?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=staphaseptic&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT
7. http://www.ncbi.nlm.nih.gov/pubmed/2145499
8. http://www.ncbi.nlm.nih.gov/pubmed/9055360
9. http://www.ncbi.nlm.nih.gov/pubmed/12451368
10. http://www.ncbi.nlm.nih.gov/pubmed/9848442
11. Bishop, C.D. (1995). "Anti-viral Activity of the Essential Oil of Melaleuca alternifolia". Journal of Essential Oil Research: 641–644