WINNING THE WAR AGAINST GINGIVITIS BY FIGHTING OFF TRENCH MOUTH

Trench mouth is a significant and painful dental condition caused by a high bacterial infection of the gums, which causes swelling, inflammation, and ulceration of the gingiva/gums; nonetheless, trench mouth is uncommon and non-contagious. This ailment can strike at any moment in your life, but it is more common in those under the age of 35. This issue primarily affects patients who have poor oral hygiene because they have high amounts of bacteria that cause gum infection. This is easily treatable and curable; but, if left untreated, it can cause major harm to not just your mouth but also your jawbones.

What Is NUG Aka Vincent Infection & Trench Mouth?
Vincent's infection, commonly known as necrotizing ulcerative gingivitis (NUG), is a kind of gingivitis with distinct signs and symptoms. The free gingival margin and the interdental papilla are the first areas to be affected by this disease. Interdental ulcers, pain, and bleeding are all considered diagnostic. The condition was originally known as "acute necrotising ulcerative gingivitis (ANUG)," but researchers have stopped using the word "acute" because there is no chronic variant of it.

NUG is a polymicrobial infectious disease that occurs in combination with other predisposing conditions, producing severe tissue loss. In plaque samples from damaged tissues, French physician Jean Vincent discovered fusiform bacillus and a spirochete, Borrelia vincentii, in 1904. Other organisms like as Prevotella intermedia, Treponema species, and Porphyromonas gingivalis have now been discovered in this situation. It is clear that the fusiform bacillus, now known as Fusobacterium nucleatum, and Borrelia vincentii, may be found in both healthy oral cavities and illnesses such as herpetic gingivostomatitis. This emphasizes the notion that predisposing conditions may cause a disruption in the host-fusospirochetal interaction, resulting in an increase in the number of disease-causing organisms.

Why Is It Called Trench Mouth?
Psychological stress, as well as immunosuppression or lowered susceptibility to infection, are thought to have a role in the development of NUG. This was especially evident during World War I, when soldiers in the battlefield trenches suffered from NUG in huge numbers due to poor hygienic conditions and an inadequate diet, earning the disease the nickname "trench mouth."

Symptoms
Trench mouth is characterized by a foul odor (halitosis), pasty saliva, continual gnawing radiating pain that is aggravated by spicy or hot foods and chewing, bleeding, red and swollen gums, and other symptoms. This disorder is extremely unusual in a normal/healthy population (0.1 percent), however it becomes more common in people who are extremely stressed. NUG starts on the interdental papilla, which is painful and hemorrhagic, and proceeds to “punched-out” erosion regions that bleed when touched. After that, the ulcers are covered in a pseudo-membranous necrotic slough. The ulceration may spread to other gingival edges after it starts with any interdental papilla.

Patients may experience extreme gingival pain and bleeding, making eating difficult. Another symptom of this disease is a metallic taste in the saliva as well as fetid breath, which can be very unpleasant. Other secondary symptoms include fever, malaise, and lymphadenopathy. This process is known as necrotizing ulcerative periodontitis if it affects the periodontium with a loss of attachment, and it is known as necrotising ulcerative stomatitis if it involves neighboring soft tissues. This illness could potentially go through the mucosa and affect the skin on the face. The condition is then known as Noma or cancrum oris.

Causes Of Trench Mouth
When there is an overabundance of pathogenic microorganisms, trench mouth develops. Gums become infected, resulting in painful ulcers. Viruses may be to blame for the bacteria's excessive growth. Smoking, local trauma, poor dental hygiene, low nutritional status, insufficient sleep, and upper respiratory tract infections are all possible risk factors. NUG can also affect patients who have significant immunosuppression as a result of HIV. This ailment mainly affects young to middle-aged people, although it can also afflict youngsters in poorer nations who are malnourished.

Complications
Because NUG does not go away on its own, it is critical that you take the required steps to treat it as soon as possible. If action is not taken, the infection could spread throughout the mouth, causing bone damage. Dehydration, tooth loss, tissue loss in the cheeks, lips, or jawbone, discomfort, infection spread, and periodontitis are some of the problems.

Treatment
The oral cavity can be cleaned with warm salt water rinses, chlorhexidine, and diluted hydrogen peroxide to treat NUG. Scaling and polishing can be used in addition to this. The debridement operations may necessitate the use of topical anaesthetic. Antibiotics such as penicillin and metronidazole may be helpful if used in conjunction with debridement techniques in many circumstances. In most cases, re-contouring of the punched-out papillae is required. Patients should be instructed on proper dental hygiene, and any predisposing factors such as smoking should be avoided, as well as stress. Because NUG recurs frequently, patients should be followed up on a regular basis and their dental hygiene should be evaluated on a regular basis to rule out recurrence.

Symptoms should subside in 24 to 48 hours when combined with chlorhexidine, a prescription antibiotic mouthrinse, and saline (mild saltwater) rinses. However, in order to be effective, NUG treatment is usually given for two weeks. Salt water rinses, hydrogen peroxide rinses, over-the-counter pain relievers, antibiotics, brushing and flossing, and professional dental cleaning are some of the treatment options for NUG.

Trench mouth is treated by:

• Using an ultrasonic tool or chemical agents, dead tissue is removed (debridement) from affected areas.
• If the patient has a weakened immune system, a fever, or swollen glands, oral antibiotics should be used.
• The use of analgesics.

Prevention
Poor dental hygiene is the primary cause of trench mouth in the majority of instances. As a result, by brushing, flossing, and using mouthwash on a regular basis, this can be avoided. Smoking is a key cause of trench mouth and should be avoided at all costs.

Actions to prevent trench mouth:

• Good overall health, including good nutrition and exercise
• Brushing, flossing, and professional cleaning are all examples of good oral hygiene
• Healthy coping with stress
• Smoking should be avoided.
• Irritants, such as hot or spicy foods, should be avoided.

Conclusion
Trench mouth is a rapidly spreading gum infection characterized by bleeding, swelling, pain, ulcers between the teeth, and gum tissue loss. Trench mouth is a more advanced and serious form of gingivitis, a frequent type of gum disease, and due to the threat of death (necrosis) to the teeth's supporting systems. Fairywill's toothbrushes water-flossers and other oral hygiene products are specially equipped to handle gingivitis before it progresses to trench mouth.