Trench mouth

Trench mouth
History, etiology,predisposing factor ,clinical features,histology,treatment necrotizing ulcerative gingivitis,Vincent's infection.

1. TRENCH MOUTH

2. History World war 1 & 2: origin of the term. Allied troops suffered from these disease. Uncommon in developed countries. Global increase associated with HIV infections. TRENCH MOUTH

3. Vincent infection Necrotizing ulcerative gingivitis Acute ulcerative gingivitis SYNONYMS

4. DEFINITION “It is a non-contagious anaerobic inflammatory destructive disease of the gingiva which associated with overwhelming proliferation of Borrelia vincentii and Fusiform bacillus presenting characteristic signs and symptoms.”

5. T he reasons for the change in terminology from acute necrotizing ulcerative gingivitis (ANUG) to necrotizing gingivitis (NG)? If the lesion is indeed capable of progression from gingivitis to periodontitis, the lesion cannot technically remain exclusively ‘acute’. Because superficial necrosis always involves an ulcer, the use of the term “ulcerative” may be somewhat superfluous. Additionally, the terminology was eliminated because the ulceration was considered to be secondary to the necrosis.

6. Spirochete Fusiform bacilli ETIOLOGY It is an endogenous,polymicrobial infection causing destructive inflammation due to the coexistance of several Most investigators believe that NG is caused by Fusiform bacilli and Borellia vincentii . Some experimental studies showed that B.intermedius was responsible for the signs and symptoms of the disease . B.melaninogenicus , a motile gram negative anaerobic bacillus, was also implicated as a causative agent for NG Predisposing factors

7. Predisposing factors

8. Clinical features Painful hyperemic gingiva Sharply punched out, crater like erosion of interdental papillae Ulcerated remnants of papillae Free gingiva bleed when touched Covered Grayish green necrotic pseudomembrane Fetid odour Inability to eat Pain Headache, malaise Low grade fever Excessive salivation Metallic taste Regional lymphadenopathy Incubation zone recurrence Systemic manifestations leukocytosis, GI disturbances, tachycardia Other features

9. Sharply punched out, crater like erosion of interdental papillae

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