Acute gingivitis, also known as acute necrotizing ulcerative gingivitis (ANUG), is a serious and painful condition characterized by the presence of inflammation, discoloration of the gums, and ulcerated tissue within the oral cavity. Commonly known as trench mouth, acute gingivitis originates in the presence of a bacterial imbalance that triggers the development of an infection. Treatment for acute gingivitis usually involves the administration of antibiotics and professional cleaning. Some cases may require surgery to repair the damage caused by severe ulceration and tissue death.
Normally, there is a healthy bacterial presence in the human mouth that works to maintain a delicate balance to help with digestion and promote immunity. Uncontrolled bacterial production can upset the established bacterial balance and trigger the development of an infection, namely gingivitis. In the presence of acute gingivitis, the soft tissues comprising the gums ulcerate allowing debris to accumulate and further promote the development of infections. Eventually forming larger sores or ulcers, the affected tissues begin to break down, contributing to widespread tissue death.
A diagnosis of acute necrotizing gingivitis is usually confirmed with a visual inspection of the inside of the mouth by an oral surgeon or dentist trained to recognize the telltale signs of this condition. After an initial examination, additional diagnostic tests are usually recommended to assess the condition of the affected area and assess the degree of damage and infection present. In most cases, x-rays and a throat culture can be done to check for the presence of bacteria at the root of the infection.
Acute gingivitis is a condition that must have an ideal environment to thrive, therefore certain situations and conditions can increase the risk of becoming symptomatic. Those who are susceptible to chronic oral infections or have compromised immunity are considered to be at increased risk of developing acute gingivitis. Other factors that can contribute to its development include poor oral hygiene, malnutrition, and tobacco use.
People with acute gingivitis often experience a gradual onset of signs and symptoms that get progressively worse without proper treatment. The most prominent signs of this condition are pain and inflammation of the gums. As the pain worsens, the individual may develop bleeding gums that occurs with minimal contact or pressure and persistent halitosis, or bad breath. The affected tissues eventually ulcerate, forming sores that are filled with food debris and other foreign matter that contribute to the development of the infection. Over time, affected gum tissues can become discolored, taking on a gray or dark appearance that is indicative of tissue necrosis or death.
Treatment for acute gingivitis is generally multifaceted in its approach and requires proactive measures on the part of the symptomatic individual. Initial treatment requires the administration of antibiotic medications to eliminate unnecessary bacterial growth, eradicate the infection, and stabilize the bacterial balance within the mouth. Professional cleaning is a necessary part of treatment to remove foreign matter and decomposed tissue. Severe cases of necrosis may require oral surgery to repair extensive damage to the gums and surrounding tissues.
People are encouraged to use an antiseptic mouthwash and brush regularly as their gums begin the healing process, which usually takes a few weeks. Proactive personal hygiene is essential to eliminate infection and prevent reinfection. After all signs of infection have passed, it is essential that people continue to be proactive with their oral hygiene to decrease their risk of future infection.