Trench Mouth

Written by Brian Krans and Kristeen Cherney | Published on May 14, 2015
Medically Reviewed by George Krucik, MD, MBA on May 14, 2015

Overview

Trench mouth is a severe gum infection caused by a buildup of bacteria in the mouth. It’s characterized by painful, bleeding gums and ulcers in the gums. Your mouth naturally contains a balance of healthy bacteria, fungi, and viruses. However, poor dental hygiene can cause harmful bacteria to grow. Red, sensitive, and bleeding gums are symptoms of a condition known as gingivitis. Trench mouth is a rapidly progressing form of gingivitis. 

The term trench mouth can be traced back to World War I, when it was common for soldiers to experience severe gum problems because they didn’t have access to dental care while in battle. It’s formally known as: 

  • Vincent’s stomatitis
  • acute necrotizing ulcerative gingivitis
  • necrotizing ulcerative gingivitis

Trench mouth is most common in teenagers and younger adults. It’s a serious condition, but it’s rare. It’s most common in underdeveloped nations and areas with poor nutrition and living conditions.

Learn more about this serious oral infection and ways to prevent and manage the symptoms.

What Causes Trench Mouth?

Trench mouth is caused by an infection of the gums due to the overabundance of harmful bacteria. If you have gingivitis, you’re already at a higher risk of developing this advanced infection.

Trench mouth has also been linked to the following risk factors:

  • poor dental hygiene
  • poor nutrition
  • smoking
  • stress
  • a weakened immune system
  • infection of the mouth, teeth, or throat
  • HIV/AIDS
  • diabetes

The infection worsens and damages gum tissue if it’s left untreated. This can lead to a host of problems, including ulcers and possible tooth loss.

Symptoms of Trench Mouth

It’s important to recognize the symptoms of trench mouth so you can get timely treatment and prevent complications. While the symptoms of trench mouth are similar to those of gingivitis, they tend to progress more rapidly.

Symptoms of trench mouth include:

  • bad breath or a bad taste in the mouth
  • bleeding in response to irritation (such as brushing) or pressure
  • crater-like ulcers in the mouth
  • fatigue
  • fever
  • grayish film on the gums
  • gums that are red, swollen, or bleeding
  • pain in the gums

How Is Trench Mouth Diagnosed?

A dentist can usually diagnose trench mouth during an examination. Your dentist may gently prod your gums to see how easily they bleed when poked. They may also order X-rays to see if the infection has spread to the bone beneath your gums.

Your doctor may check for other symptoms, such as fever or fatigue. They might also draw your blood to check for other, possibly undiagnosed conditions. HIV infection and other immune problems can promote the growth of bacteria in your mouth.

Treating Trench Mouth

With treatment, trench mouth can typically be cured in a matter of weeks. Treatment will include antibiotics to stop the infection from spreading further, pain relievers, professional cleaning from a dental hygienist, and proper ongoing oral hygiene.

Brushing and flossing your teeth thoroughly twice a day are important for controlling the symptoms of trench mouth. Warm salt water rinses and rinsing with hydrogen peroxide can ease the pain of inflamed gums and also help remove dead tissue.

It’s also recommended that you avoid smoking and hot or spicy foods while your gums heal.

Living with Trench Mouth

Regular and effective dental care is crucial for preventing trench mouth from returning. While the condition rarely has serious side effects, ignoring symptoms can lead to potentially serious complications, such as:

  • tooth loss
  • destruction of gum tissue
  • trouble swallowing
  • oral diseases that can damage bone and gum tissue
  • pain 

To avoid complications of trench mouth, make sure you take the following steps regularly:

  • brush and floss your teeth twice a day, especially after a meal (electric toothbrushes are recommended)
  • avoid tobacco products, including cigarettes and chew
  • eat a healthy diet
  • keep your stress level down

Managing pain during the healing process is also key. Over-the-counter pain relievers (such as acetaminophen and ibuprofen) are typically enough to control pain, but talk to your doctor before use.

Outlook

Trench mouth is a serious oral health problem. This advanced infection is relatively rare in developed countries thanks to access to preventive care. Trench mouth continues to be an issue in developing nations because of a lack of oral care tools. The best way to prevent dental problems like trench mouth is to make sure you take care of your teeth and gums with regular flossing and brushing. You should also continue to see your dentist twice a year so they can detect any potential problems before those issues escalate into severe infections.   

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