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Trench Mouth: Understanding ANUG and Its Impact on Oral Health

When it concerns your oral well-being, there are certain terms you might not be familiar with. “Trench Mouth” happens to be one of them.

It is also known as Acute Necrotizing Ulcerative Gingivitis (ANUG). It is an oral condition that can severely affect oral health if not treated on time.

In this blog, you will learn about trench mouth disease, its symptoms, available diagnosis, gingivitis treatment, its impact on oral health, etc.

For any oral problems, do not hesitate to call Peace of Mind Dental Studio, Chandler.

Trench Mouth

Trench mouth or Acute Necrotizing Ulcerative Gingivitis (ANUG) is a severe and painful gum infection causing inflammation, crater-like ulcers, and tissue damage in the mouth. Bacteria are permanent residents in your mouth, but when you lack oral hygiene, smoke, or stress excessively, and the bacterial growth increases manifold, it leads to a trench mouth. The discomfort is unbearable, and the problem must be addressed in time.

It was a common condition of soldiers during World War I, as they lived in trenches and experienced this painful problem. That’s where Trench mouth has earned its name from.

Pathophysiology of Acute Necrotizing Ulcerative Gingivitis (ANUG)

There are a lot of factors behind the pathophysiology of ANUG, which lead to the characteristic symptoms and tissue damage associated with the condition. Here’s an overview of the pathophysiological processes:

Bacterial Overgrowth

It is the major cause of ANUG. It begins with the overgrowth of bacteria in your oral cavity. One of the primary culprits is the bacterium Fusobacterium. These bacteria grow exponentially due to poor oral hygiene, stress, smoking, and a weak immune system.

Invasion of Gum Tissues

There are tissues between your gum and tooth called gingival sulcus. When these bacteria grow, they invade this tissue, penetrating the gap and causing irritation and inflammation.

Tissue Damage, Pain and Discomfort

As the problem persists, you can see the grey film on your gum, the greyish patches of dead tissues. The gums become inflamed and damaged, which causes extreme pain and discomfort, increasing daily. It can make everyday activities, such as eating and speaking, extremely painful.

Systemic Effects

Trench mouth is not just a simple gum infection but a severe problem and must be treated within time. If not, the bacteria enter the bloodstream, leading to systemic problems.

Diagnosis and Differential Diagnosis of ANUG

You must visit a dentist if you see any symptoms of trench mouth. The diagnosis of trench mouth includes:


Look out for the symptoms that suggest trench mouth. These symptoms include:

  • Severe gum pain and tenderness
  • Swollen and inflamed gums
  • Ulceration of the gingival tissues
  • The presence of pseudo membranes (grayish patches) on the gums
  • Foul breath or a metallic taste in the mouth
  • Excessive salivation

Medical and Dental History

Your dentist will require your complete dental history to look for potential risk factors and other conditions that might contribute to the development of ANUG.

Oral Examination

A thorough examination by a professional dentist is important. The dentist will evaluate your oral cavity, focusing on your teeth, gums, and surrounding tissues.


A biopsy is rare but sometimes required to confirm the diagnosis. A small sample of your affected tissue is taken and sent to the laboratory to diagnose ANUG.

Differential Diagnosis

Some other oral health conditions may present symptoms similar to trench mouth, making a differential diagnosis essential. These conditions include:


Multiple forms of gingivitis cause gum inflammation and discomfort, but not every form suggests a trench mouth, thus making differential diagnosis important.


Advanced stages of gum disease, such as periodontitis, can also lead to gum pain, swelling, and tissue damage. A thorough examination is crucial to distinguish between these conditions.

Oral Infections

Oral infections might have similar symptoms to trench mouth. Every infection type requires a specific treatment plan.

Systemic Conditions

Your overall health is reflected in your mouth. Severe health conditions like leukemia may also lead to symptoms similar to ANUG.

Allergic Conditions

Allergic reactions to dental products or medications may lead to gum symptoms, although they are less common.

Accurate diagnosis of ANUG is crucial to kickstart the much-needed treatment. If you experience gum pain and discomfort, do not hesitate to  get an appointment with Peace of Mind Dental Studio, Chandler.

Treatment and Management

You must know that trench mouth doesn’t go away on its own. You must seek prompt treatment if you suspect you have trench mouth. Here are the steps typically involved in treating trench mouth:

See A Dentist

The symptoms of trench mouth have been discussed above. If you experience them, book an appointment with Peace of Mind Dental Studio.


Based on the diagnosis of trench mouth, the dentist will clean the damaged tissues and gums. They make you rinse your mouth with antiseptic mouthwash, which cleanses any lingering bacteria. The dentist will also prescribe pain medication and antibiotics. These antibiotics may be taken orally or applied topically, depending on the severity of the infection.

Warm Saltwater Rinse

Warm salt water rinses twice or thrice daily will help soothe your gums and reduce inflammation.

Pain Management

Over-the-counter or prescription pain relievers can manage pain and discomfort associated with trench mouth.

Oral Hygiene

Prevention is always better than cure. Maintain a proper oral hygiene. Brush twice a day, floss your teeth regularly, and use an antimicrobial mouthwash.

Avoid Smoking and Alcohol

Smoking and alcohol can aggravate the condition. Avoid these bad habits if you have a trench mouth.

Trench Mouth Treatment at Peace of Mind Dental Studio

Trench mouth can be painful and uncomfortable, but you can fully recover with prompt and appropriate treatment. Do not ignore your oral problems, even the smallest ones, such as bleeding gums or pain. Consult our expert dentists today, and let us help you get rid of trench mouth.

Frequently Asked Questions

Que: Can I treat trench mouth at home?

Ans: Apparently, trench mouth is a severe bacterial infection that cannot be treated at home. The dentist removes the damaged tissues from your gums and cleans them, which cannot be achieved at home.

Que: Is trench mouth contagious?

Ans: No, trench mouth is not contagious in itself. However, the patient must avoid close contact with healthier individuals or sharing items like toothbrushes.

Que: Can trench mouth be prevented?

Ans: Yes, trench mouth can be prevented by maintaining a good oral hygiene regime.

Written by Dr. Silverman

Dr. Silverman is the co-founder of Peace of Mind Dental, a Chandler Arizona, general dentistry practice.