Acute Necrotizing Ulcerative Gingivostomatitis

Last updated: February 8, 2026Reviewed date: February 8, 2026Reading time: 6 min read
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Acute Necrotizing Ulcerative Gingivostomatitis
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Acute necrotizing ulcerative gingivostomatitis (ANUG), also known as Vincent's angina or trench mouth, is a severe form of gingivitis (gum disease) that can cause painful, infected ulcers to develop in the gums and other areas of the mouth. ANUG is caused by a bacterial infection,...

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বাংলা রোগী নোট এখনো যোগ করা হয়নি। পোস্ট এডিটরে “RX Bangla Patient Mode” বক্স থেকে সহজ বাংলা সারাংশ যোগ করুন।

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Article Summary

Acute necrotizing ulcerative gingivostomatitis (ANUG), also known as Vincent's angina or trench mouth, is a severe form of gingivitis (gum disease) that can cause painful, infected ulcers to develop in the gums and other areas of the mouth. ANUG is caused by a bacterial infection, typically by a combination of bacteria, including spirochetes and fusiform bacilli. The condition often affects people with compromised immune systems...

Key Takeaways

  • This article explains Causes in simple medical language.
  • This article explains Symptoms in simple medical language.
  • This article explains Diagnosis in simple medical language.
  • This article explains Treatment in simple medical language.
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Definition

Acute necrotizing ulcerative gingivostomatitis (ANUG), also known as Vincent’s angina or trench mouth, is a severe form of gingivitis (gum disease) that can cause painful, infected ulcers to develop in the gums and other areas of the mouth.

ANUG is caused by a bacterial infection, typically by a combination of bacteria, including spirochetes and fusiform bacilli. The condition often affects people with compromised immune systems or poor oral hygiene, and it can also be exacerbated by factors such as stress, smoking, and poor nutrition.

Causes

Acute necrotizing ulcerative gingivostomatitis (ANUG) is a severe form of gingivitis that causes infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।" data-rx-term="inflammation" data-rx-definition="Inflammation is the body’s response to injury, infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।">inflammation and necrosis of the gum tissues. The main causes of ANUG are poor oral hygiene, a weakened immune system, and smoking.

  1. Poor oral hygiene: ANUG is caused by bacterial overgrowth in the mouth, which can occur due to poor oral hygiene. Failure to brush and floss regularly can lead to the accumulation of plaque and tartar, which provide a breeding ground for harmful bacteria.
  2. Weakened immune system: Individuals with weakened immune systems are at greater risk of developing ANUG. This may occur as a result of medical conditions such as HIV/AIDS, cancer, or autoimmune diseases, or due to medications that suppress the immune system.
  3. Smoking: Smoking is a significant risk factor for ANUG. Nicotine and other chemicals in tobacco smoke can damage the oral tissues and compromise the immune system’s ability to fight off infections.

Other contributing factors that may increase the risk of developing ANUG include poor nutrition, stress, and hormonal changes. It is essential to seek professional dental care if you notice symptoms of ANUG, such as severe gum pain, bleeding, and bad breath, to prevent further complications.

Symptoms

Acute necrotizing ulcerative gingivostomatitis (ANUG), also known as Vincent’s angina or trench mouth, is a severe gum infection caused by the bacteria fusobacterium and spirochetes. The main symptoms of ANUG include:

  1. Painful, bleeding gums: The gums are red, swollen, and painful to touch. They may also bleed easily, especially during brushing or eating.
  2. Ulcers: Small, crater-like sores may develop on the gums, tongue, or inside of the cheeks. These sores can be very painful and make it difficult to eat or speak.
  3. Bad breath: ANUG can cause a foul odor in the mouth due to the bacteria and dead tissue.
  4. Fever and malaise: Some people with ANUG may experience a fever, pain in the head or upper neck. সহজ বাংলা: মাথাব্যথা।" data-rx-term="headache" data-rx-definition="Headache means pain in the head or upper neck. সহজ বাংলা: মাথাব্যথা।">headache, and overall feeling of illness.
  5. Enlarged lymph nodes: The lymph nodes in the neck may become swollen and tender.

If you experience any of these symptoms, it’s important to see a dentist or doctor for proper diagnosis and treatment. ANUG can be treated with antibiotics, pain relievers, and proper oral hygiene. In severe cases, surgery may be needed to remove damaged tissue.

Diagnosis

The main diagnosis of ANUG is based on clinical symptoms and examination of the oral cavity by a dentist or oral health professional.

The following are the main clinical symptoms of ANUG:

  • Painful, bleeding, and ulcerated gums
  • Bad breath or halitosis
  • Metallic taste in the mouth
  • Swollen lymph nodes in the neck
  • Fever and malaise

A dental professional may use a dental probe to check the depth of the pockets around the teeth and determine the extent of the infection. X-rays may also be taken to assess the bone and tooth structures.

In addition to the clinical diagnosis, laboratory tests may also be performed to confirm the diagnosis of ANUG. These may include:

  • Culture and sensitivity test: A sample of the oral tissue or discharge may be collected and sent to the lab to identify the bacteria causing the infection and determine the best antibiotics to treat it.
  • Complete blood count (CBC): A blood test to check the white blood cell count, which can indicate the presence of infection.
  • C-reactive protein (CRP) test: A blood test to check the level of CRP, a protein produced by the liver in response to infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।" data-rx-term="inflammation" data-rx-definition="Inflammation is the body’s response to injury, infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।">inflammation.

It is essential to seek prompt treatment for ANUG to prevent the infection from spreading and causing serious complications, such as sepsis, osteomyelitis, or Ludwig’s angina. Treatment may involve antibiotics, pain relief, and oral hygiene measures, such as rinsing with saltwater or chlorhexidine mouthwash.

Treatment

The main treatment of acute necrotizing ulcerative gingivostomatitis (ANUG) is a combination of professional dental care and medication.

Professional dental care may involve:

  1. Scaling and root planing: This involves cleaning the teeth and roots to remove plaque and tartar.
  2. Debridement: This involves removing the dead tissue and debris from the affected area.
  3. Oral hygiene instructions: This involves teaching the patient how to maintain proper oral hygiene, such as brushing and flossing.
  4. Antibiotics: Antibiotics may be prescribed to help control the infection.
  5. Pain management: Pain relief medication may be prescribed to manage the pain associated with ANUG.

It is important to seek treatment for ANUG as soon as possible, as the infection can spread and cause more serious health problems.

  1. https://www.ncbi.nlm.nih.gov/books/NBK11733/
  2. https://www.ncbi.nlm.nih.gov/books/NBK208/
  3. https://www.ncbi.nlm.nih.gov/books/NBK212/
  4. https://www.ncbi.nlm.nih.gov/books/NBK92761/
  5. https://www.ncbi.nlm.nih.gov/books/NBK11733/
  6. https://www.nccih.nih.gov/health/skin-conditions-at-a-glance
  7. https://www.aad.org/public/diseases/a-z
  8. https://medlineplus.gov/skinconditions.html
  9. https://www.aad.org/about/burden-of-skin-disease
  10. https://www.usa.gov/federal-agencies/national-institute-of-arthritis-musculoskeletal-and-skin-diseases
  11. https://www.cdc.gov/niosh/topics/skin/default.html
  12. https://www.skincancer.org/
  13. https://www.jaad.org/
  14. https://www.psoriasis.org/about-psoriasis/
  15. https://books.google.com/books?
  16. https://www.niams.nih.gov/health-topics/skin-diseases
  17. https://cms.centerwatch.com/directories/1067-fda-approved-drugs/topic/292-skin-infections-disorders
  18. https://www.fda.gov/files/drugs/published/Acute-Bacterial-Skin-and-Skin-Structure-Infections—Developing-Drugs-for-Treatment.pdf
  19. https://dermnetnz.org/topics
  20. https://www.aaaai.org/conditions-treatments/allergies/skin-allergy
  21. https://www.sciencedirect.com/topics/medicine-and-dentistry/occupational-skin-disease
  22. https://aafa.org/allergies/allergy-symptoms/skin-allergies/
  23. https://www.nibib.nih.gov/
  24. https://rxharun.com/resources/category/resources/rxharun/article-types/skin-care-beauty/skin-diseases-types-symptoms-treatment/
  25. https://www.nei.nih.gov/
  26. https://en.wikipedia.org/wiki/List_of_skin_conditions
  27. https://en.wikipedia.org/?title=List_of_skin_diseases&redirect=no
  28. https://en.wikipedia.org/wiki/Skin_condition
  29. https://oxfordtreatment.com/
  30. https://www.nidcd.nih.gov/health/
  31. https://consumer.ftc.gov/articles/w
  32. https://www.nccih.nih.gov/health
  33. https://catalog.ninds.nih.gov/
  34. https://www.aarda.org/diseaselist/
  35. https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets
  36. https://www.nibib.nih.gov/
  37. https://www.nia.nih.gov/health/topics
  38. https://www.nichd.nih.gov/
  39. https://www.nimh.nih.gov/health/topics
  40. https://www.nichd.nih.gov/
  41. https://www.niehs.nih.gov
  42. https://www.nimhd.nih.gov/
  43. https://www.nhlbi.nih.gov/health-topics
  44. https://obssr.od.nih.gov/
  45. https://www.nichd.nih.gov/health/topics
  46. https://rarediseases.info.nih.gov/diseases
  47. https://beta.rarediseases.info.nih.gov/diseases
  48. https://orwh.od.nih.gov/

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