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Acute Necrotizing Ulcerative Gingivitis

  • Cynthia M. Johnson, MA
Publication Type:


Acute Necrotizing Ulcerative Gingivitis

(ANUG; Trench Mouth; Vincents Stomatitis)


Acute necrotizing ulcerative gingivitis (ANUG) is a serious infection of the gums.


The exact cause is not known. It happens when the mouth has excess bacteria in it.

Risk Factors

This problem is more common in people who are 24 years of age and younger. The risk is higher in people who have excess bacteria in the mouth due to:

  • Lack of dental care
  • Poor dental hygiene
  • Poor diet
  • Vitamin deficiencies
  • Infections in the throat, teeth, or mouth
  • A weak immune system
  • Smoking
  • Stress


A person with ANUG may have:

  • Fever
  • Red and swollen gums
  • Gums that bleed easily
  • Gum pain
  • Bad taste in the mouth or very bad breath
  • Gray buildup on the gums
  • Large sores or loss of gum in between teeth
Red and Swollen Gums.

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The doctor will ask about symptoms and health history. A dental exam will be done.

Images may be taken of the teeth and face. This can be done with x-rays.

Dental X-ray.

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Any underlying causes will need to be treated, such as helping with nutrition and dental care.

The goals of treatment are to ease pain and stop the disease from getting worse. Ways to do this are:

  • Dental surgery to remove damaged tissue
  • Antibacterial mouthwash
  • Medicine to:
    • Ease pain
    • Treat infection


The risk of ANUG may be lowered by:

  • Practicing good oral hygiene
  • Eating a healthful diet
  • Managing stress




  • Acute necrotizing ulcerative gingivitis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/acute-necrotizing-ulcerative-gingivitis.
  • Acute necrotizing ulcerative gingivitis. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/dental-disorders/periodontal-disorders/acute-necrotizing-ulcerative-gingivitis-anug.


  • James Cornell, MD
Last Updated:

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.