OF ALL the diseases affecting the human race, gum disease, also called periodontitis, happens to be the second most prevalent one. However, it should be noted that this condition is not a single entity. While various kinds exist, there is a special type of gum disease which is seen mainly in persons between 15 and 35 years old. Unlike any other, it is painful and generally attacks its victims in groups.
This infection is called acute ulcerative necrotising gingivitis or ‘trench-mouth’. The pattern of the spread of ‘trench-mouth’ on many occasions indicates that it is contagious, although some authorities do not accept this. In any case, its occurrence in groups of persons may be due to prevailing factors in the similar conditions under which they live.
The disease is characterised by the appearance of pain, redness and erosions of the papilas (the projections of gum between teeth). In fact, the gum line (where the gum meets the teeth) becomes necrotic and bleeds when touched.
Often, a grayish film covers the ulcer, which may eventually spread along the entire gum line. Finally, typically fetid bad breath appears that is usually obnoxious. The patient almost always complains of inability to eat, due to sensitivity or intense pain to the gums. The type of pain experienced is a superficial ‘pressure’. Usually, the patient suffers from headache, malaise and low fever (37.2 to 39 degrees centigrade).
Excessive secretion of saliva, accompanied by a metallic taste, is often noted. The lymph glands of the neck can also be detected. In advanced or severe cases, there may be generalized or systemic manifestations, including an elevated white blood cell count, gastrointestinal disturbances, and an accelerated heartbeat.
After healing, the papilas, which have been destroyed, may leave a cavernous zone constituting an area that retains germs. This region can serve as an incubation site where the disease could erupt anytime in the future.
The majority of researchers believe that ‘trench-mouth’ is a primary disease caused by a fusiform bacillus (rod-shaped) together with a spiroquet (cork-screw)-shaped organism called borrelia vincentii. Because these two microorganisms frequently exist in many healthy mouths, it obviously suggests that some other predisposing factor is involved in the actual cause of the infection whenever it erupts.
To confirm this, scientists have never been able to induce ‘trench-mouth’ artificially in persons. The most important factor which predisposes someone to contracting ‘trench-mouth’, according to recent evidence, is a lower resistance to infection, especially as a consequence of vitamin C and B complex deficiency.
One author who studied the epidemic, which attacked thousands of combatant soldiers during the Second World War, established that ‘trench-mouth’ appeared in the presence of chronic fatigue, deficient food and precarious oral hygiene. Undoubtedly, psychologically stressful circumstances also play an important role.
The treatment of ‘trench-mouth’ is extremely variable, depending on the individual experience of the dentist with the disease. Some prefer to treat this condition conservatively by  instituting superficial cleaning of the mouth in the initial stage, followed by scaling and polishing when the situation permits. Others opt for oxidizing agents or antibiotics, in collaboration with local therapy.
In many cases, there is a marked regression within two days of the treatment, even without medication. It is reported that occasionally, complications of this disease, such as oral gangrene, septicemia, toxemia (blood poisoning) and even death itself can occur in extreme cases.
Fortunately, ‘trench-mouth’ is not common in Guyana.