Trench Mouth

Trench mouth is a type of gingivitis. It is a sudden (acute) infection that affects the gum tissue between your teeth. This infection quickly kills the gum tissue and causes painful sores (ulceration). Trench mouth causes severe gum pain, very bad breath, and bleeding gums. The infection is not passed from person to person.

What are the causes?

The mouth normally contains a healthy balance of certain bacteria that are usually present in the mouth. Trench mouth occurs when that balance is upset because of an unhealthy mouth environment that allows these bacteria to grow out of control.

What increases the risk?

You are more likely to develop this condition if you:

• Are 18–35 years old.
• Have any condition that can upset the balance of bacteria in your mouth, such as thrush (candidiasis) or cold sores (herpes simplex).
• Are under emotional or physical stress.
• Do not practice good mouth care (oral hygiene).
• Have a cut, burn, or other injury in the mouth (oral trauma).
• Smoke or chew tobacco.
• Have any condition or disease that weakens your body’s defense system (immunesystem).
• Have another type of gingivitis or inflammation of the mouth (stomatitis).

What are the signs or symptoms?

Symptoms of this condition include:

• Severe gum and mouth pain.
• Red, swollen gums that bleed easily.
• Ulcerations of gum tissue between your teeth.
• Very bad breath and a foul taste in your mouth.
• Fever.
• Swollen glands (lymph nodes).
• Tiredness (fatigue).
• A gray or yellow film in your mouth from a buildup of dead tissue (pseudomembrane).

How is this diagnosed?

This condition may be diagnosed based on your medical history and a physical exam. You may also have:

• X-rays of your face and teeth. These are used to check for disease in your sinuses and tooth roots.
• A sample of fluid collected from your throat and checked under a microscope for overgrowth of bacteria (cultures).

How is this treated?

This condition may be treated with a thorough cleaning of your teeth and gums. This is done by a dentist or oral surgeon. During this cleaning:

• Topical or injected medicine will be used to numb your mouth (local anesthetic).
• Dead tissue and pseudomembrane will be removed (debridement).
• Debridement will be repeated several times, until the infection clears up.

Treatment may also include:

• Using a mouth rinse that contains antibiotic medicines, numbing medicines, or antiseptics.
• Taking antibiotic medicines by mouth (orally).
• Taking medicine for pain.

Follow these instructions at home:

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.
• If you were prescribed an antibiotic medicine, take it as told by your health care provider. Do not stop taking the antibiotic even if you start to feel better.
• If you were prescribed a mouth rinse, use it as told by your health care provider.

Eating and drinking

• Drink enough fluid to keep your urine pale yellow.
• Drink high-nutrition and high-calorie shakes or supplements.
• Eat bland and soft foods that are easy to eat.
• Do not eat citrus foods or foods that are hot or spicy.
• Do not drink alcohol.

Lifestyle

• Get plenty of rest and sleep and try to reduce your stress.
• Ask your health care provider what activities you should avoid while your gums are healing.
• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.

General instructions

• Rinse your mouth with a salt-water mixture 3–4 times a day or as needed. To make a salt-water mixture, completely dissolve ½–1 tsp of salt in 1 cup of warm water.
• Do not brush or floss your teeth until your health care provider says it is okay. When your health care provider says you can start brushing your teeth again, brush gently with a soft toothbrush two times a day. Floss daily.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have a fever.
• Your pain is not controlled with medicine.
• Your symptoms do not improve with treatment.

Get help right away if you:

• Develop pain or swelling in your face or jaw.
• Cannot eat or drink.
• Have trouble breathing or swallowing.
• Have a rapid heart rate.

Summary

• Trench mouth is an infection that kills the gum tissue between your teeth and causes painful sores (ulceration).
• Trench mouth causes severe gum pain, very bad breath, and bleeding gums.
• Treatment for trench mouth starts with a thorough cleaning of your teeth and gums by a dentist or oral surgeon. You may also need to take oral antibiotic medicine or use a mouth rinse that contains antibiotic medicines, numbing medicines, or antiseptics.
• Rinse your mouth with a salt-water mixture 3–4 times a day or as needed. When your health care provider says you can start brushing your teeth again, brush gently with a soft toothbrush two times a day. Floss daily.