Trench mouth

Trench mouth is an infection that causes swelling (inflammation) and ulcers in the gums (gingivae). The term trench mouth comes from World War I, when this infection was common among soldiers "in the trenches."

Causes

Trench mouth is a painful form of gum swelling ( gingivitis ). The mouth normally contains a balance of different bacteria. Trench mouth occurs when there is too much normal mouth bacteria. The gums become infected and develop painful ulcers . Viruses may be involved in allowing the bacteria to grow too much.

Gingivitis

Gingivitis is inflammation of the gums.

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Ulcers

An ulcer is a crater-like sore on the skin or mucous membrane. Ulcers form when the top layers of skin or tissue have been removed. They can occur ...

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Things that increase your risk of trench mouth include:

• Emotional stress

  Stress

  Stress is a feeling of emotional or physical tension. It can come from any event or thought that makes you feel frustrated, angry, or nervous. Stres...

  

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• Poor oral hygiene

  Oral hygiene

  Tooth decay and gum disease are caused by plaque, a sticky combination of bacteria and food. Plaque begins to build up on teeth within 20 minutes af...

   

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• Poor nutrition
• Smoking
• Throat, tooth, or mouth infections

Trench mouth is rare. When it does occur, it most often affects people ages 15 to 35.

Symptoms

Symptoms of trench mouth often begin suddenly. They include:

• Bad breath

  Bad breath

  Breath odor is the scent of the air you breathe out of your mouth. Unpleasant breath odor is commonly called bad breath.

   

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• Crater-like ulcers between the teeth
• Fever
• Foul taste in the mouth
• Gums appear red and swollen
• Grayish film on the gums
• Painful gums
• Severe gum bleeding in response to any pressure or irritation

Exams and Tests

The health care provider will look into your mouth for signs of trench mouth, including:

• Crater-like ulcers filled with plaque and food debris
• Destruction of gum tissue around the teeth
• Inflamed gums

There may be a gray film caused by broken down gum tissue. In some cases, there may be fever and swollen lymph nodes of the head and neck.

Dental x-rays or x-rays of the face may be taken to determine how severe the infection is and how much tissue has been destroyed.

This disease may also be tested for by using a throat swab culture .

Throat swab culture

A throat swab culture is a laboratory test that is done to identify germs that may cause infection in the throat. It is most often used to diagnose ...

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Treatment

The goals of treatment are to cure the infection and relieve symptoms. Your health care provider may prescribe antibiotics if you have a fever.

Good oral hygiene is vital to the treatment of trench mouth. Brush and floss your teeth thoroughly at least twice a day, or after each meal and at bedtime, if possible.

Salt-water rinses (one half teaspoon or 3 grams of salt in 1 cup or 240 milliliters of water) may soothe sore gums. Hydrogen peroxide, used to rinse the gums, is often recommended to remove dead or dying gum tissue. Chlorhexidine rinse will help with gum inflammation.

Over-the-counter pain relievers may reduce your discomfort. Soothing rinses or coating agents may reduce pain, especially before eating. You may apply lidocaine to your gums for severe pain.

Pain relievers

Over-the-counter (OTC) pain relievers can help relieve pain or lower a fever. Over-the-counter means you can buy these medicines without a prescript...

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You may be asked to visit a dentist or dental hygienist to have your teeth professionally cleaned and to have the plaque removed, once your gums feel less tender. You may need frequent dental cleaning and examinations until the disorder is cleared.

To prevent the condition from coming back, your provider may give you instructions on how to:

• Maintain good general health, including proper nutrition and exercise
• Maintain good oral hygiene
• Reduce stress
• Stop smoking

Avoid irritants such as smoking and hot or spicy foods.

Outlook (Prognosis)

The infection usually responds to treatment. The disorder can be quite painful until it is treated. If trench mouth is not treated promptly, the infection can spread to the cheeks, lips, or jawbone. It can destroy these tissues.

Possible Complications

Complications of trench mouth include:

• Dehydration
• Loss of teeth
• Pain

  Pain

  Periodontitis is inflammation and infection of the ligaments and bones that support the teeth.

   

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• Periodontitis

  Periodontitis

  Periodontitis is inflammation and infection of the ligaments and bones that support the teeth.

   

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• Spread of infection

When to Contact a Medical Professional

Call the dentist if you have symptoms of trench mouth, or if fever or other new symptoms develop.

Prevention

Preventive measures include:

• Good general health
• Good nutrition
• Good oral hygiene, including thorough tooth brushing and flossing
• Learning ways to cope with stress
• Regular professional dental cleaning and exams
• Stopping smoking