Updated on February 9, 2024
4 min read

Trench Mouth Symptoms, Causes & Treatment

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What is Trench Mouth?

Trench mouth, also known as acute necrotizing ulcerative gingivitis (ANUG), is a severe form of gingivitis. It’s also sometimes referred to as Vincent’s disease or Vincent’s angina.

Like gingivitis in general, trench mouth involves painful gums that bleed easily. However, with trench mouth, the gums are infected with destructive bacteria that cause the gum tissue to die.

teeth with plaque and red gums from gingivitis

The term trench mouth derives from World War I. Soldiers in trenches suffered extreme conditions with limited medical care. As a result, many developed this form of gingivitis, even though it is not contagious.

How Common is Trench Mouth?

Today, trench mouth is a rare disease. It’s more likely to be found in areas with poor nutrition and sanitation. People who are immunocompromised in developed countries can also develop trench mouth.

Untreated trench mouth can spread to other parts of the mouth and face, leading to severe disfigurement or even death. However, this is rare, and trench mouth can be treated well before these complications develop.

Symptoms of Trench Mouth

One key way to distinguish trench mouth from typical gingivitis or gum disease is the amount of pain and bleeding. Even severe gum disease is often not painful.

Trench mouth, on the other hand, can cause more noticeable symptoms, including:

  • Painful, swollen gums that bleed easily
  • Crater-like ulcers on the gums, including between the teeth
  • Severe bad breath
  • A persistent bad taste, sometimes described as metallic

Some people may also have a gray film in their mouth caused by dead gum tissue. If allowed to spread beyond the gums, trench mouth may end up causing fever, fatigue, or general malaise.

If you notice symptoms like the above, you should see a dentist or doctor as soon as possible.

What Causes Trench Mouth?

Your mouth is home to various bacteria and other microorganisms. Many of them cause no harm, largely due to your immune system.

Certain conditions or situations can damage your gums and/or weaken your immune system. Trench mouth can then develop as certain bacteria have an opportunity to grow unchecked.

Possible risk factors for trench mouth include:

  • Systemic diseases such as HIV, AIDS, and diabetes that suppress your immune system 
  • Immunosuppressant medications
  • Poor oral hygiene
  • Malnutrition 
  • Smoking
  • Previous or existing gum disease or injury
  • Other recent illness
  • Psychological stress

All of these factors can make your gums more vulnerable to infection. They compromise the protection provided by your immune system.

How is Trench Mouth Diagnosed?

A general dentist or health care provider may be able to diagnose trench mouth with an oral examination. However, they must also rule out other conditions that can cause similar symptoms, such as leukemia.

To be sure of the underlying cause, your dentist or doctor may do the following:

  • Visually examine your mouth for signs of ulceration and dead tissue
  • Ask you about your symptoms, including pain
  • Probe your gums to see how easily they bleed
  • Take X-rays
  • Take a blood sample to test for HIV, leukemia, or other conditions

How to Treat Trench Mouth

The goal of treatment for trench mouth is to cure the condition and relieve symptoms. If you have symptoms of trench mouth, you should see your dentist as soon as possible.

If you have trench mouth, it’s unlikely that your condition will improve without professional treatment. Home remedies will not cure trench mouth, though they can help to manage and prevent it.

Professional Treatment

Treatment for trench mouth typically includes a professional cleaning to remove bacteria, tartar, and dead tissue. Your dentist or periodontist may apply a numbing agent to prevent pain during the cleaning.

The recovery process for trench mouth may take several weeks. You may require multiple cleanings until you’ve recovered.

In addition to professional cleaning, your dentist or periodontist may prescribe the following medications:

  • Antibiotics to kill the bacteria causing the infection
  • A prescription-grade mouthwash (such as chlorhexidine mouthwash)
  • Pain medication to alleviate pain and discomfort while you recover

Home Remedies

During recovery, mouth rinses and over-the-counter pain medication can help you manage the pain. You’ll also want to practice good oral hygiene and avoid irritants like spicy foods. Be sure to follow your dentist’s recommendations for recovery.

Your dentist may also recommend lifestyle changes, such as quitting smoking and improving your diet. These changes will help to improve your oral health and prevent future infections.

Trench Mouth Complications

Left untreated, trench mouth can spread to the cheeks, lips, or jawbone. These tissues get destroyed by the infection, resulting in life-altering disfigurement. If it spreads throughout the body, the infection can be fatal.

Other risks and complications of trench mouth include:

  • Dehydration
  • Fever
  • Weight loss
  • Tooth loss
  • Pain 
  • Advanced gum disease (periodontitis)

If you have severe gum pain or other symptoms of trench mouth, seek professional treatment as soon as possible.


Trench mouth, also known as Vincent’s disease, is a severe bacterial infection of the gums. It’s more painful than typical gum disease and involves the death of the gum tissue.

This illness is rare but serious. If you have painful gums that bleed easily, a gray film over your gums, or other signs of trench mouth, make an appointment with your dentist or periodontist as soon as possible.

Last updated on February 9, 2024
6 Sources Cited
Last updated on February 9, 2024
All NewMouth content is medically reviewed and fact-checked by a licensed dentist or orthodontist to ensure the information is factual, current, and relevant.

We have strict sourcing guidelines and only cite from current scientific research, such as scholarly articles, dentistry textbooks, government agencies, and medical journals. This also includes information provided by the American Dental Association (ADA), the American Association of Orthodontics (AAO), and the American Academy of Pediatrics (AAP).
  1. Jacob, Jaise, et al. “Trench mouth: Is it a disease of the past? Diagnostic clincher: The underrated ‘urgent smear.’” Journal of Current Research in Scientific Medicine, 2019.
  2. Malek, Rayhana, et al., “Necrotizing Ulcerative Gingivitis.” Contemporary Clinical Dentistry, 2017.
  3. Chaubal, Tanay, and Ranjeet Bapat. “Trench Mouth.” The American Journal of Medicine (Online Communication to the Editor), 2017.
  4. Leão, Jair Carneiro, et al. “Ulcerative Lesions of the Mouth: An Update for the General Medical Practitioner.” Clinics, 2007.
  5. Wiler, Jennifer L. “Quick Consult: Symptoms: Bad Breath, Painful Gums, ‘White Stuff.’” Emergency Medicine News, 2014.
  6. Sheng, Sally, et al. “Necrotizing periodontal disease in a nutritionally deficient patient: A case report.” Frontiers in Dental Medicine, 2022.
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