Presentation
Three specific clinical characteristics must be present to diagnose NUG, pain (usually of rapid onset) interdental necrosis, and bleeding. [ncbi.nlm.nih.gov]
Immune System
- Cervical Lymphadenopathy
Other signs and symptoms include malaise, fever, cervical lymphadenopathy, and the presence of fusobacteria and oral spirochetes. Occurs rarely in developed areas. [visualdx.com]
Cervical lymphadenopathy What is the treatment of Vincent's angina? 1. Systemic: High antibiotics, penicillin and its derivatives very effective. 2. Local a. Sodium Perborate paste is spread over the ulcer. [specialist-ent.com]
Initial signs and symptoms include halitosis; thick, increased oral secretions; bleeding gums; and localized cervical lymphadenopathy. [journals.lww.com]
Entire Body System
- Pain
The often severe gingival pain that characterizes ANUG distinguishes it from the more common chronic periodontitis which is rarely painful. [en.wikipedia.org]
[…] necrotizing ulcerative gingivitis * * * a progressive painful infection, also seen in subacute and recurrent forms, marked by crateriform lesions of interdental papillae with pseudomembranous slough circumscribed by linear erythema; fetid breath; increased [medicine.academic.ru]
NUG is different from other periodontal diseases in that it presents with interdental necrosis, “punched out” ulcerated papillae, gingival bleeding and pain. [jcda.ca]
- Fever
Often, the lymph nodes under the jaw swell, and a mild fever develops. [merckmanuals.com]
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. [mountsinai.org]
It is usually accompanied by systemic signs of fever, malaise and cervical and submandibular lymphadenopathy. It is caused by the profileration of anaerobic bacteria and has been linked to smoking and immunosuppression. [ncbi.nlm.nih.gov]
- Malaise
It is usually accompanied by systemic signs of fever, malaise and cervical and submandibular lymphadenopathy. It is caused by the profileration of anaerobic bacteria and has been linked to smoking and immunosuppression. [ncbi.nlm.nih.gov]
[…] punched out) of papillae ( Figs. 1 and 2 ) Intense gingival pain Bleeding gingiva with little or no provocation Secondary features: Fetid breath, yellowish-white or grayish slough “pseudomembrane” covering ulcerated papilla, lymphadenopathy, fever and malaise [jcda.ca]
Other signs and symptoms include malaise, fever, cervical lymphadenopathy, and the presence of fusobacteria and oral spirochetes. Occurs rarely in developed areas. [visualdx.com]
Symptoms and Signs of ANUG The usually abrupt onset may be accompanied by malaise or fever. [msdmanuals.com]
Gastrointestinal
- Choking
The word "angina" comes from the Latin "angere" meaning "to choke or throttle." [medterms.com]
The word “angina” is derived from the Latin word “angere” which means “to choke or to throttle.” [mynewsmile.com]
Jaw & Teeth
- Poor Oral Hygiene
It is concluded that these entities occur only in children from low socioeconomic groups and have a multifactorial etiology consisting of poor oral hygiene and malnutrition. [ncbi.nlm.nih.gov]
It is usually associated with poor oral hygiene, immunosuppression, smoking, local trauma, poor nutritional status, inadequate sleep, or recent illness and psychological stress. [medical-dictionary.thefreedictionary.com]
Risk factors may include poor oral hygiene, tobacco use, pre-existing oral infection, and a weakened immune system (as from poor nutrition or emotional stress). — called also fusospirochetosis, necrotizing ulcerative gingivitis, trench mouth, Vincent's [merriam-webster.com]
When poor oral hygiene is combined with serious life stress and possibly nutritional deficiencies, the result can be Acute Necrotizing Ulcerative Gingivitis, or ANUG. Another name of it is trench mouth. [mynewsmile.com]
- Bleeding Gums
a severe form of gingivitis that is marked especially by painful, bleeding gums with ulcers and is associated with the proliferation of microorganisms (such as the bacteria Fusobacterium nucleatum and Treponema vincentii ) that are normally part of [merriam-webster.com]
Alerts and Notices Synopsis Periodontal disease commonly called trench mouth, or Vincent's angina, characterized by painful, erythematous, bleeding gums, malodorous breath, and necrosis and ulceration of connective gum tissue. [visualdx.com]
NUG diagnosis is based on three essential symptoms: sore gums, bleeding gums and the most diagnostic characteristic, ulceration and necrosis of the interdental papillae. [ncbi.nlm.nih.gov]
The chief symptoms are painful, swollen, bleeding gums; small, painful ulcers covering the gums and tooth margins; and characteristic fetid breath. The ulcers may spread to the throat and tonsils. Fever and malaise may also be present. [britannica.com]
- Halitosis
Halitosis/ bad taste which again can be severe. These symptoms are caused by the by-products of the bacteria that eat the gingival tissues – Not pleasant! Ulcers on the gums. [dentalcarematters.com]
[…] 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 [mytooth.net]
‘Oral cavity conditions that can produce halitosis are dentures, chronic periodontal disease, coated tongue and Vincent's angina.’ [en.oxforddictionaries.com]
Oral malodor (intraoral halitosis). Bad taste (metallic taste).Malaise, fever and/or cervical lymph node enlargement are rare (unlike the typical features of herpetic stomatitis). Pain is fairly well localized to the affected areas. [en.wikipedia.org]
Symptoms and signs include: Severe deep pain – main symptom Spontaneous bleeding – usual Halitosis (bad breath) – usual Multiple sites of gum necrosis - usual Loss of alveolar bone – usual Pseudomembrane formation – very common Lymph gland enlargement [dermnetnz.org]
- Bad Taste
In addition to ulcers, other common symptoms of ANUG include painful gums, bad taste in the mouth, bad breath, mild to severe gum bleeding, a grayish film on the gums, and severe discomfort while eating/swallowing. [diseaseinfosearch.org]
taste in the mouth; extremely bad breath Red and swollen gums Gray residue on the gums Large ulcers or loss of gum tissue in between teeth Fever Discomfort Swollen lymph nodes Copyright © Nucleus Medical Media, Inc. [health.cvs.com]
taste in the mouth; extremely bad breath Red and swollen gums Gray residue on the gums Large ulcers or loss of gum tissue in between teeth Fever Discomfort Swollen lymph nodes Red and Swollen Gums Copyright © Nucleus Medical Media, Inc. [winchesterhospital.org]
In addition, the patient complains of a bad taste in the mouth and a fetid bad breath. On examination, there is a deep well circumscribed unilateral ulcer of one tonsil. The base of the ulcer is gray and bleeds easily when scraped with a swab. [ghorayeb.com]
- Gingival Ulceration
As with most poorly understood diseases, Vincent's angina goes by many other names including acute membranous gingivitis, fusospirillary gingivitis, fusospirillosis, fusospirochetal gingivitis, necrotizing gingivitis, phagedenic gingivitis, ulcerative [medterms.com]
Skin
- Ulcer
[…] site acute necrotising ulcerative gingivitis acute necrotising ulcerative gingivitis [Ambiguous] acute necrotising ulcerative gingivostomatitis acute necrotising ulcerative gingivostomatitis [Ambiguous] acute necrotizing ulcerative gingivitis acute necrotizing [wikidata.org]
Necrotizing ulcerative gingivitis/periodontitis Classification and external resources ICD 10 A69.1 ICD 9 … Wikipedia acute necrotizing ulcerative gingivitis — n a progressive painful disease of the mouth that is marked esp. by dirty gray ulceration of [medicine.academic.ru]
Acute necrotizing ulcerative gingivitis is a common, non-contagious infection of the gums with sudden onset. The main features are painful, bleeding gums, and ulceration of inter-dental papillae (the sections of gum between adjacent teeth). [en.wikipedia.org]
Acute necrotizing ulcerative gingivitis (ANUG): This is trench mouth, a progressive painful infection with ulceration, swelling and sloughing off of dead tissue from the mouth and throat due to the spread of infection from the gums. [medterms.com]
- Cutaneous Manifestation
manifestations Canker sores Best Tests Subscription Required References Subscription Required Last Updated: 07/14/2016 [visualdx.com]
Psychiatrical
- Anger
The word "angina" comes from the Latin "angere" meaning "to choke or throttle." [medterms.com]
The word “angina” is derived from the Latin word “angere” which means “to choke or to throttle.” [mynewsmile.com]
Workup
Microbiology
- Treponema Pallidum
Abstract The purpose of this investigation was to determine whether monoclonal antibodies against pathogen-restricted antigens of Treponema pallidum subsp. pallidum could be used as probes for spirochetes in diseased gingival tissue from subjects with [ncbi.nlm.nih.gov]
Molecular basis of immunological cross-reactivity between Treponema pallidum and Treponema pertenue. Infect Immun 1983 ; 42: 634 –8. 7. Thornburg RW, Baseman JB.. [nejm.org]
An unnamed spirochete related to Treponema pallidum has been identified in acute necrotizing ulcerative gingivitis lesions [37]. [gulfdoctor.net]
Necrotizing Stomatitis in mandibular left molar area This lesions are due to infections with: - Neisseria gonorrhea -Treponema pallidum -Streptococci -Mycobacterium chelonae The gingival lesions manifest • Fiery red edematous painful ulcerations • Asymptomatic [intranet.tdmu.edu.ua]
- Capnocytophaga
The analyses showed that the fusiform taxa (Fusobacterium nucleatum/Fusobacterium periodonticum, Leptotrichia buccalis, Tannerella forsythensis, and Capnocytophaga sp.), Campylobacter rectus, Prevotella intermedia, Prevotella nigrescens, Selenomonas sputigena [ncbi.nlm.nih.gov]
- Borrelia Burgdorferi
Serum samples from 18 persons who had gingivitis or periodontitis but no history of lyme borreliosis were tested by enzyme-linked immunosorbent assay for Antibodies to Borrelia burgdorferi [48]. [gulfdoctor.net]
Treatment
The purpose of this paper is to review the treatment modalities of acute necrotizing ulcerative gingivitis and illustrate an alternative treatment approach of periodic scaling, root planing, and antimicrobial rinses with 0.12% chlorhexidine. [ncbi.nlm.nih.gov]
Figure 3: 24 h post treatment presenting reduction of erythematous margins and edema. Figure 4: Closer view 24 h after treatment. [jcda.ca]
Treatment of Acute Necrotizing Ulcerative Gingivitis The main goals of the treatment of Acute Necrotizing Ulcerative Gingivitis are to stop the infection, relieve the symptoms and restore the damaged gum tissue using: Antibiotics and Pain Relief Medications [mouthandteeth.com]
Treatment is aimed first at relieving the symptoms and then the underlying or pre-disposing conditions that led to it. [deardoctor.com]
Prognosis
Prognosis/Outlook for Necrotizing Ulcerative Gingivitis or Trench Mouth As with any existent disease in the world, the sooner you are diagnosed with Necrotizing ulcerative gingivitis or trench mouth, the better your dental health prognosis/ outlook is [epainassist.com]
Failure to treat acute periodontal diseases appropriately can result in progressive loss of periodontal supporting tissues, an adverse change in prognosis, and could result in tooth loss. [dx.doi.org]
Prognosis NUG responds very well to treatment and usually can be cured. [sabkadentist.com]
Etiology
Data suggest that the etiology and pathogenesis of necrotizing periodontal diseases may also be distinctive from other periodontal diseases. [ncbi.nlm.nih.gov]
The etiology is uncertain, but fusiform bacilli, spirochetes, and other microorganisms are present in the lesions; many postulate an etiology of a bacterial complex in the presence of predisposing factors such as gingival disease or nutritional deficiency [medicine.academic.ru]
Epidemiology
Current literature on the epidemiology, pathogenesis, immunology, predisposing factors, and treatment of ANUG/NUP is reviewed. [ncbi.nlm.nih.gov]
Albandar, Epidemiology and Risk Factors of Periodontal Diseases, Dental Clinics of North America, 49, 3, (517), (2005). [doi.org]
Pathophysiology
This literature review will provide a better understanding of the epidemiology, etiology, and pathophysiology of ANUG associated with malnutrition. [ncbi.nlm.nih.gov]
Prevention
Orthodontists should be aware of the clinical signs of NUG to ensure early detection and treatment of their patients in order to prevent irreversible loss of the interdental papillae and reduce the likelihood of recurrence. [ncbi.nlm.nih.gov]
The most important preventive measure against developing Necrotizing ulcerative gingivitis or Trench Mouth is good oral hygiene. Paying a visit to dentist every six months is also a good way to prevent necrotizing ulcerative gingivitis. [epainassist.com]
Treatment of ANUG is by debridement (although pain may prevent this) and antibiotics (usually metronidazole) in the acute phase, and improving oral hygiene to prevent recurrence. [en.wikipedia.org]