The Causes and Treatment of Trench Mouth

By Donna G. Wagner, R.D.H.

Trench mouth, a noncontagious disease also known as Vincent's angina and Vincent's stomatitis, flourished in the trenches during during World War I. It was brought on by exhaustion, emotional stress, and poor health conditions, such as deficient diets, tobacco use, insufficient rest, and poor oral hygiene. All these conditions conspired to cause two microorganisms of the mouth to invade its susceptible tissues. If untreated, this caused extreme pain as the bacteria attacked the gum tissue, causing a gray membrane composed of the bacteria and dead or necrotic tissue to appear which would slough off when touched, leaving raw bloody tissue underneath.

Left: Acute Case Affecting Gums & Hard Palate; Right: Less Severe but Painful Case

Often the first sign was that the soldier's breath would become extremely foul. Ulcerations on the papilla, or points between the teeth would cause them to become blunted and gaps would show between the teeth at the roots. Swallowing became painful as lymph nodes in the throat would swell. Eventually, supporting bone would deteriorate.

Treatment during World War I would have consisted of warm saltwater rinses, hydrogen peroxide application or rinses, and, if possible, better food and removal of the patient from the stressful trench area. Today the disease is treated in the same manner, but with the addition of antibiotics such as tetracycline or amoxicillin. The disease is mainly seen today in people with extremely depressed immune systems. Mild forms are found in college students at exam time, people with high stress levels, or heavy tobacco users. Formally, it is called Acute Necrotizing Ulcerative Gingivitis, or ANUG.