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acute necrotising ulcerative gingivitisA condition characterised by progressive necrosis of intraoral tissues and upper respiratory abscesses, which is seen in those with poor oral hygiene and suboptimal nutrition, often linked to herpes simplex and anaerobic flora—e.g., Fusobacterium spp, spirochetes.
Acute necrotizing ulcerative gingivitis (ANUG) appears to be the most appropriate for a polymicrobial (‘fusospirochetal’) gingival infection that most commonly occurs in a back-group of malnutrition, stress and poor oral hygiene; with time the ulcerating or ulceromembranous lesions may spread to the rest of the oral cavity.
It is also a more accurate term for the antiquated Vincent's angina, in which the infection is seated on the soft palate and tonsils.
The microbiological analysis of the lesions of ANUG, given that certain bacteria may cause acute (eg Streptococcus spp) and/or ulceromembranous (eg Corynebacterium diphtheriae) lesions.
“Trench mouth” is a coinage of World War I vintage which attributed ANUG to living in close quarters—i.e., “the trenches”.
Pain, oedema, punched-out ulcers, pseudomembrane formation, halitosis.
Erythema multiforme, lichen planus, pemphigus, bullous pemphigoid.
H2O2, antibiotics (e.g., tetracycline, if fever or lymphadenopathy), saline mouth rinse, local anaesthetics.
Pharyngitis with fever, pain, and the formation of ulcerations.
See also: pharyngitis