Acute Necrotizing Ulcerative Gingivitis
En Español (Spanish Version)

Definition
Acute necrotizing ulcerative gingivitis (ANUG) is a serious infection of the gums that causes ulcers, swelling, and dead tissues in the mouth. Although a very painful condition, it can be healed with treatment.

Causes
Acute necrotizing ulcerative gingivitis is typically caused by excess bacteria in the mouth. Too much bacteria can form in the mouth from smoking , stress, lack of dental care, a virus, and poor diet.

Risk Factors
A risk factor is something that increases your chance of getting a disease or condition. Risk factors for ANUG include:
  • Lack of dental care and overall poor dental hygiene
  • Poor diet
  • Vitamin deficiencies
  • Infections in the throat, teeth, or mouth
  • Compromised immune system
  • Smoking
  • Stress
  • Age: 35 years or younger

Symptoms
If you experience any of these symptoms, do not assume it is due to acute necrotizing ulcerative gingivitis. These symptoms may be caused by other health conditions. If you experience any one of them, see your dentist.
  • Pain in the gums
  • Gums that bleed easily
  • Bad taste in mouth, extremely bad breath
  • Red and swollen gums
  • Gray residue on the gums
  • Large ulcers or loss of gum tissue in between teeth
  • Fever
  • Swollen lymph nodes

Red and Swollen Gums

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Diagnosis
Your dentist will ask about your symptoms and medical history, and perform a dental exam. The dental exam will look for:
  • Inflammation of the gums
  • Destroyed gum tissue
  • Crater-like ulcers in the gums that may harbor plaque and debris from food
  • Dental x-rays
  • Facial x-rays

Dental X-ray

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Treatment
Talk with your dentist about the best treatment plan for you. Treatment options include the following:
  • Antibiotics to clear up the infection
  • Dental surgery
  • Improved diet
  • Regular dental cleanings
  • Changes in diet

Prevention
To help reduce your chances of getting ANUG, take the following steps:
  • Maintain a balanced, nutritional diet.
  • Take proper care of teeth and gums.
  • See your dentist regularly.




RESOURCES:
American Academy of Periodontology

American Dental Association

CANADIAN RESOURCES:
Canadian Dental Association

Canadian Dental Hygienists Association

References:
Contreras A, Falkler WA Jr, Enwonwu CO, et al. Herman herpesviridae in acute necrotizing ulcerative gingivitis in children in Nigeria. Oral Microbiol Immunol. 1997;12:259-265.

DynaMed Editorial Team. Acute necrotizing ulcerative gingivitis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated November 30, 2009. Accessed October 20, 2010.

Marquette University School of Dentistry. Acute necrotizing ulcerative gingivitis. Marquette University School of Dentistry website. Available at: http://www.dental.mu.edu/oralpath/lesions/AcuteNecrotizingUlcerativeGingivitis/acutenecrotizingulcerativeging.htm . Accessed October 20, 2010.

Mayo Clinic. Trench mouth. Mayo Clinic website. Available at: http://www.mayoclinic.com/health/trench-mouth/DS00457 . Updated July 8, 2010. Accessed October 20, 2010.

Schreiner C, Quinn FB. Stomatitis. University of Texas Medical Branch website. Available at: http://www.utmb.edu/otoref/grnds/stomatitis.htm . Accessed October 20, 2010.

Last Reviewed September 2011