What is Acute Necrotizing Ulcerative Gingivitis (ANUG)?

Acute necrotizing ulcerative gingivitis is a serious periodontal disease. It is a severe form of gum infection which causes swelling and ulceration in the mouth.  The dead tissues from the mouth and the throat slough off because of the infection that has spread from the gums. It involves an acute infection of the gingival tissues. Though it is a painful infection, it can be treated with proper treatment and medications.


Acute necrotizing ulcerative gingivitis is also known as “trench mouth” and “Vincent’s angina”. Trench mouth is named because the disease was predominance among the soldiers who were trapped in the trenches during World War I. while the name Vincent’s angina was named after famous French physician Henry Vincent.


The disease is rare in developed countries where the living is highly standard. It is widely seen in a poor or underdeveloped countries where people have inadequate nutrition and poor, below standard living conditions. The disease is vulnerable in the children of Sub-Saharan parts of Africa where there is poor living standard.


The disease is known to cause by a number of micro-organisms such as bacteria, fungi and viruses. Acute necrotizing ulcerative gingivitis is caused by the abnormal abundant growth of infectious bacteria such as anaerobic Spirochetes, Bacteroides and Fusobacterium in the mouth. The overgrowth of bacteria in the mouth can cause severe infection of the gums that can in turn result in a serious destruction of the periodontal tissues. The abnormal growth of the bacteria is initiated by some external factors.


Acute necrotizing ulceration gingivitis is highly prevalence in a patient with HIV infections or in a person with suppressed immune system. It occurs in higher ratio where the patient has immuno compromised health status or those who have weakened immune system. Males are more prevalent than the females. Adults are affected in majority than the children.

Causes or risk factors:

The disease is caused by the overgrowth of harmful bacteria in the mouth. These bacteria infect the gums and damages the underlying tissues. This can later spread to throat and result in systemic infections. Abnormal growth of bacteria is initiated by factors such as poor oral hygiene, stress, smoking, poor nutrition, tooth, throat or mouth infections and weakened immune system of the body.

Symptoms include-

  • Intense gum pain
  • Intense red gums and severe swollen gums
  • Sensitive gums that bleeds when pressed slightly
  • Ulceration or necrosis of the papillae or gingival
  • Experience pain while eating food or swallowing
  • Noticeable gray color film on the gums
  • Sore and ulcers (crater-like) in between the gums and the teeth
  • Unpleasant, foully taste in the mouth
  • Halitosis
  • Increase in the body temperature(fever)
  • Swelling of the lymph nodes (around the neck, jaw or head)
  • Formation of pseudo membrane

Prophylactics (treatments):

Trench mouth treatment is effective and can be treated completely with antibiotics. In case of immune suppressed patients (AIDS), healing may take longer time.

Antibiotics: Antibiotics such metronidazole, amoxillin, penicillin, tetracycline, doxycycline, ciprofloxacin, clindamycin etc are prescribed by the doctor to destroy bacteria and prevent the spread of the infection.

Painkillers: Prescription or over-the-counter pain killers are advice in case the patient has intense gum pain.

Other treatment procedures include gum surgery, oral hygiene, dental, gum cleaning and improved diet.


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  6. What is periodontal disease?

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