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Trench Mouth (Necrotizing Ulcerative Gingivitis)

Dental professionals worldwide continuously stress the importance of practicing good oral hygiene habits to their patients in order to manage their oral health. Unfortunately, many people still are unaware of the serious consequences of poor oral hygiene habits and the painful effects they can have on the mouth.

Necrotizing ulcerative gingivitis, better known as trench mouth, is an acute gingival infection caused by bacterial plaque. Although trench mouth is uncommon, certain people – such as malnourished children and young adults, smokers and people with immunodeficiencies – are more susceptible to this gum disease. Poor oral hygiene practices and increased levels of physical and emotional stress also are predisposing factors for trench mouth.


Trench mouth is most often characterized by significant and nearly unbearable pain, bleeding from the gums when they are pressed even gently, and necrotic and ulcerated gum tissues (resembling pockets or craters between the teeth). Symptoms may also include oral malodor and a bad taste in the mouth, a grayish film on the gums, and a feeling of overall malaise. There is a tendency for relapse after treatment.


To properly diagnose trench mouth, dentists generally perform a thorough clinical examination of your teeth and gums. To determine if the infection has caused extensive damage to the tissues, X-rays may be necessary. Your dentist also may perform other tests to eliminate the possibility of immunodeficiency and systemic diseases, or refer you to your physician.

Treatments and Costs

Trench mouth can be serious, so the sooner it is treated, the better the outcome. Treatment generally involves antibiotics, but over-the-counter or prescription pain relievers also may be needed to enable you to comfortably follow proper oral hygiene habits (brushing, flossing).

Treatment from your dentist or hygienist also involves a thorough cleaning of your teeth and gums and removal of any dead gum tissue. Further deep cleaning treatment below the gumline may be necessary from a periodontist (dentist specializing in diseases of the gums) and include local antibiotic therapies.

Eating a well-balanced diet, practicing good oral hygiene habits (brushing and flossing), drinking sufficient fluids, and getting enough rest are essential for managing your oral health. Avoid smoking and consuming spicy foods, which can irritate the gums.

The cost of trench mouth treatment depends on the medications and procedures needed to return your teeth and gums to optimal health. For example, additional scaling and root planing procedures may be required in order to remove plaque and tartar below the gumline. The average cost for periodontal scaling and root planning is approximately $140 to $210. Also, if extensive damage has occurred, periodontal surgery may be required to repair the gum tissue. The cost of periodontal surgery averages $425 up to $3,800, depending upon the severity of the case and what is needed. Keep in mind that your medical and dental insurance may cover some of the medications and procedures involved with treatment.