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Causes of Trench Mouth

Necrotizing ulcerative gingivitis, also known simply as “trench mouth,” is a type of serious gum disease named after the trenches of the First World War, where it was a particularly common and troublesome ailment (another necrotic disease, “trench foot,” took its name from the same grim conditions of that war). It usually occurs among teenagers and young adults, but even in this age group it is not common for an oral infection to progress to the stage of trench mouth before it is caught and managed.

The cause of trench mouth, like most oral and dental problems, is a bacterial infection, often prompted by poor oral hygiene which allows large colonies of bacteria to accumulate on the gums and teeth. Types of bacteria that have caused trench mouth vary, but include P. intermedia, Treponema, P. intermedia, and Fusobacterium. These bacteria are naturally occurring in the mouth. However, when they are allowed to grow out of control, harmful infections can take root in the gums. This begins with gingivitis, in which the tissue around the teeth are affected, but then progresses into more serious stages as the bacteria move deeper and deeper into the tissues of the mouth.

Trench mouth is relatively uncommon, but is a particularly serious risk in people whose immune systems are already compromised. In fact, during the 1980s and early 1990s, trench mouth experienced a resurgence as an opportunistic infection targeting patients with AIDS, the final state of the disease caused by HIV. According to the Mayo Clinic, risk factors of trench mouth (i.e. factors which increase the risk of serious oral infections) include not brushing and flossing regularly, malnutrition, tobacco use (including cigarette smoking), and severe stress, which can weaken the immune system.

If you are concerned that you have symptoms of trench mouth, you should seek medical advice, ideally from a dentist or orthodontist. If you are diagnosed with trench mouth, the necrotic (dead) tissue in the gums will be removed. You will be given mouth rinses to limit the bacterial infection, and pain relief medication to limit discomfort. Undiagnosed, the infection will continue to eat further into the periodontal tissue, and may eventually spread into the cheeks, the lips, or the jawbone. Particularly when associated with malnutrition, the worst-case scenario is noma, a form of gangrene which causes large-scale facial tissue death and disfiguration.

– Sources and More Information –

Mayo Clinic. “Trench Mouth.”

National Institutes of Health. “Trench Mouth: MedlinePlus Medical Encyclopedia.”