Trench Mouth: What You Should Know

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Trench mouth, also known as acute necrotizing ulcerative gingivitis, is a severe form of gum disease. It’s also sometimes referred to as Vincent disease or Vincent’s stomatitis. While it’s more common in people under 24, it’s a fairly rare condition overall.

The name for the disease, trench mouth, originated during World War I, when the condition was common among soldiers in the trenches. 

This article looks at the causes, symptoms, diagnosis, treatment, and prevention for this serious stage of gum disease. 

Woman at the dentist

Hispanolistic / Getty Images


The main cause of trench mouth is the presence of excess bacteria. However, experts don’t quite know the exact mechanisms behind why this condition develops. 

You’re more likely to develop trench mouth if you:

  • Don’t practice proper oral hygiene
  • Have a poor diet and vitamin or mineral deficiencies
  • Have existing oral infections
  • Are a smoker
  • Have high levels of stress
  • Have a weakened immune system

People With Weakened Immune Systems

People with weakened immune systems cannot fight off infections as easily as others and may be at higher risk for developing gum infections or diseases like trench mouth. Conditions that can weaken your immune system include:

  • Diabetes (a condition in which the body does not regulate blood sugar adequately)
  • HIV (a viral infection that impairs the immune system) 
  • Cancer or cancer treatment 
  • Any condition that requires you to take immunosuppressants


Possible symptoms of trench mouth may include:

  • Bleeding gums
  • Swollen gums
  • Redness of the gums
  • Pain in the gums
  • Bad taste in the mouth
  • Gray color on the gums
  • Very bad breath
  • Sores on the gums
  • Loss of gums between teeth
  • Fever
  • Swollen lymph nodes

People with trench mouth may also have a severe buildup of plaque.

What Happens If Trench Mouth Isn’t Treated

If left untreated a trench mouth infection can lead to complications such as:

  • Tooth loss
  • Pain
  • Severe infection that spreads 
  • Dehydration
  • Weight loss

In some cases, untreated trench mouth can lead to oral gangrene, also known as noma or cancrum oris. This is often fatal.


A dentist will typically be the one to diagnose trench mouth during a dental exam. The dentist may take X-rays to check whether the infection has damaged any underlying tissue. They can also use throat swabs to diagnose this kind of infection. 


Keeping the disease from progressing is the main goal of treatment. Because trench mouth is a serious form of gum disease, improving nutrition and oral care may not be enough to stop the disease from getting worse.

A dentist may also recommend:

  • Surgery to get rid of dead or damaged tissue
  • Medication for pain relief
  • Antibiotics or other medications to treat any infection present 
  • Lidocaine gel to soothe severe gum pain
  • A prescription mouthwash consisting of 0.12% chlorhexidine gluconate

Treatment will also usually involve addressing the underlying issue contributing to trench mouth. Often, this involves improving dental hygiene. For some, treatment may involve improving nutrition.

Good Oral Hygiene

If you have trench mouth your dentist may recommend taking steps to improve your oral hygiene which can help with symptoms and prevent a recurrence. This entails:

  • Brushing teeth twice a day
  • Flossing thoroughly after meals
  • Rinsing with salt water, which can help with pain and inflammation 
  • Rinsing with hydrogen peroxide, which can help remove dead tissue 
  • Regular professional cleanings


You can limit your risk of developing trench mouth by:

  • Keeping good oral hygiene habits like regularly brushing your teeth
  • Going to the dentist on a regular basis 
  • Eating a healthy diet that meets your nutritional needs
  • Managing your stress levels


Trench mouth is a serious stage of gum disease that can be painful and cause symptoms that disrupt your life. A dentist can diagnose trench mouth by doing an oral exam. 

Treatment usually involves a combination of strategies to help prevent the disease from getting worse. Your dentist may recommend medication, surgery, or other options to help treat trench mouth.

A Word From Verywell

If you have this serious form of gum disease, you may feel embarrassed or uncomfortable. Don’t let these feelings stop you from seeking treatment. Without treatment, symptoms will get worse. A dentist can help treat the disease and alleviate symptoms that are causing you undue stress and anxiety.

Frequently Asked Questions

  • What does trench mouth look like?

    It depends on the person. Some people may have severe redness and swelling of the gums. If the issue is caused by poor dental hygiene, the person may have tooth decay in addition to gum disease. In some cases, the gums may take on a gray hue.

  • What antibiotics are used to treat trench mouth?

    The most commonly prescribed antibiotic for trench mouth is Flagyl (metronidazole). Other medications that a medical professional may prescribe include:

    • Penicillin
    • Tetracyclines
    • Amoxicillin
    • Clindamycin 
  • How long does trench mouth last?

    Treatment should alleviate symptoms within a few days, but it’s important to continue with any recommendations or medications prescribed by your doctor or dentist. 

6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Winchester Hospital. Acute necrotizing ulcerative gingivitis.

  2. Malek R, Gharibi A, Khlil N, Kissa J. Necrotizing ulcerative gingivitisContemp Clin Dent. 2017;8(3):496-500. doi:10.4103/ccd.ccd_1181_16

  3. Martos J, Ahn Pinto KV, Feijó Miguelis TM, et al. Clinical treatment of necrotizing ulcerative gingivitis: a case report with 10-year follow-up. Gen Dent. 2019;67(3):62-65. PMID: 31199747

  4. Mount Sinai. Trench mouth.

  5. Hu J, Kent P, Lennon JM, Logan LK. Acute necrotising ulcerative gingivitis in an immunocompromised young adultBMJ Case Rep. 2015;2015:bcr2015211092. doi:10.1136/bcr-2015-211092

  6. Srour ML, Marck K, Baratti-Mayer D. Noma: overview of a neglected disease and human rights violationAm J Trop Med Hyg. 2017;96(2):268-274. doi:10.4269/ajtmh.16-0718

By Steph Coelho
Steph Coelho is a freelance health writer, web producer, and editor based in Montreal. She specializes in covering general wellness and chronic illness.