• Acute Necrotizing Ulcerative Gingivitis

    (ANUG; Trench Mouth; Vincents Stomatitis)


    Acute necrotizing ulcerative gingivitis (ANUG) is a serious infection of the gums that causes ulcers, swelling, and dead tissues in the mouth.


    Acute necrotizing ulcerative gingivitis is typically caused by excess bacteria in the mouth.

    Risk Factors

    ANUG most often impacts people who are 35 years of age and younger. Factors that may increase the risk of ANUG include excess bacteria in the mouth due to:
    • Lack of dental care
    • Poor dental hygiene
    • Poor diet
    • Vitamin deficiencies
    • Infections in the throat, teeth, or mouth
    • A weak immune system
    • Smoking
    • Stress


    Symptoms may include:
    • Pain in the gums
    • Gums that bleed easily
    • Bad 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
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    You will be asked about your symptoms and medical history. A dental exam will be done.
    Images may be taken of your teeth and face. This can be done with x-rays.
    Dental X-ray
    Jaw x-ray teeth
    Copyright © Nucleus Medical Media, Inc.


    Although ANUG is a painful condition, it can be treated. Treatment may include:
    • Antibacterial mouthwash
    • Pain control with nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen
    • Dental surgery
    • Regular dental cleanings
    • Antibiotics to treat infection
    • Changes in diet


    To help reduce your chances of ANUG:
    • Take proper care of teeth and gums.
    • See your dentist regularly.
    • Eat a balanced diet.


    American Academy of Periodontology http://www.perio.org

    Mouth Healthy—American Dental Association http://www.mouthhealthy.org


    Canadian Dental Association http://www.cda-adc.ca

    Dental Hygiene Canada http://www.dentalhygienecanada.ca


    Acute Necrotizing Ulcerative Gingivitis. Merch Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/dental-disorders/periodontal-disorders/acute-necrotizing-ulcerative-gingivitis-anug. Updated June 2017. Accessed August 21, 2017.

    Atout RN, Todescan, S, J Can Dent Assoc 2013;79:d46. Available at: http://www.jcda.ca/article/d46. Accessed September 18, 2017.

    Revision Information

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