Dental problems
Dentoalveolar Injuries
Odontogenic Infections
Trench Mouth (Acute Necrotizing Ulcerative Gingivitis)
Background
- Severe gingival disease
- Must distinguish from herpes gingivostomatitis
- Herpes has more systemic signs, less bleeding, lack of interdental papilla involvement
- Associated with immunosuppression, especially HIV
Clinical Features
- Triad of:
- Pain
- Ulcerated or "punched out" interdental papillae
- Gingival bleeding
- Secondary signs:
- Fetid breath
- "Wooden teeth" feeling
- Teeth mobility
- Fever
- Malaise
Treatment
- Chlorhexidine 0.01% oral rinse BID
- Metronidazole 500mg PO TID
- Dental debridement and scaling
See Also
Source
- ER Atlas
- Tintinalli
- UpToDate