RT Book, Section
A1 Jauch, Edward C.
A1 Valdez, J. Amadeo
A2 Knoop, Kevin J.
A2 Stack, Lawrence B.
A2 Storrow, Alan B.
A2 Thurman, R. Jason
SR Print(0)
ID 1181040678
T1 Trench Mouth (Acute Necrotizing Ulcerative Gingivitis)
T2 The Atlas of Emergency Medicine, 5e
YR 2021
FD 2021
PB McGraw-Hill
PP New York, NY
SN 9781260134940
LK accessemergencymedicine.mhmedical.com/content.aspx?aid=1181040678
RD 2024/04/24
AB Painful,  severely  edematous  interdental  papillae  are  characteristic  of  acute  necrotizing  ulcerative  gingivitis  (ANUG),  or  trench  mouth.  Other  associated  features  include  the  presence  of  ulcers  with  an  overlying  grayish  pseudomembrane  and  a  “punched  out”  appearance.  The  inflamed  gingival  tissue  is  friable  and  necrotic  and  represents  an  acute  destructive  disease  process  of  the  periodontium.  Fever,  malaise,  and  regional  lymphadenopathy  are  commonly  associated  signs.  Patients  may  also  complain  of  foul  breath  and  a  strong  metallic  taste.  Poor  oral  hygiene,  emotional  stress,  smoking,  and  immunocompromised  states  (eg,  HIV,  steroid  use,  diabetes)  all  predispose  for  ANUG.  Anaerobic  Fusobacterium  and  spirochetes  are  the  predominant  bacterial  organisms  involved.  The  anterior  incisor  and  posterior  molar  gingival  regions  are  the  most  commonly  affected  oral  tissues.  Acute  herpetic,  gonococcal,  or  streptococcal  gingivostomatitis,  aphthous  stomatitis,  desquamative  gingivitis,  and  chronic  periodontal  disease  may  mimic  ANUG.