THE DENTIST ADVISES

Dr. BERTRAND R. STUART DDS.
Oral infections vary in severity according to a person’s susceptibility and resistance. Generally, the healthier you are, the more resistant you are likely to be, but even where general health is good, the health of the gums may be poor. Not infrequently a balance is reached between the host – you – and the invading organisms, in which case a standoff occurs. The condition becomes chronic, ever present but in a rather mild form. Also, many dental infections are due not to the introduction of new organisms but to an increase in the virulence of the viruses and bacteria normally present in the mouth, particularly as your resistance decreases.
Because we are all likely to have the same organisms in our mouths, the more common dental infections are not contagious. It is lowered resistance to our own bugs rather than invasion by others that causes most diseases of the mouth. So, by so called French kissing someone with a mouth full of rotten teeth will not cause any harm to the other person (except perhaps psychologically).
Trench mouth, Vincent’s infection, and ANUG are interchangeable names for acute necrotizing ulcerative gingivostomatitis. Marginal gingivitis is frequently a precursor of the ulceration and degeneration (or necrosis) of the gums that characterizes ANUG. The interdental papilla between each tooth looks (punched out,” and the surrounding gum cuff is loose and raw. The odour coming from the mouth is extremely offensive and this alone gives the dentist an accurate diagnosis.
If untreated or if superimposed on a more serious illness that affects gum tissue, such anemia or leukemia, ANUG becomes progressively worse, destroying the underlying periodontal bone and extending to other tissues. Such extensive infection is rare today since the disease responds well to therapy. In addition, unless the person is isolated from civilization, help is usually sought from early onset.
Microscopic examination of infected tissues reveals an unusually large number of fusiforms and spirochetes, bacteria that are always present in our mouth, though normally in lesser numbers. ANUG is associated with lowered resistance, stress, poor nutrition, and poor oral hygiene. I saw many cases when I worked as the dentist for the Mazaruni Prison.
Trench Mouth is often seen among young persons, especially during adolescence and the early twenties. In World War I it cropped up in epidemic numbers among the troops in trenches, giving rise to the term “trench mouth.” Epidemic outbreaks also occur among students during examination week. However, the epidemic is not caused by the communication of the fusospirochetes to others but by the shared stress, fatigue, and neglected oral hygiene that lower the resistance of many members of group simultaneously.
The tissue is covered by a gray pseudornembrane that peels off, leaving a red, raw surface that bleeds easily and is extremely painful to touch. There is usually a foul smell, and the patient frequently has a fever and feels listless.
The infection is not contagious. It responds quickly to antibiotics, usually penicillin. Simpler remedies such as frequent rinsing with a dilute solution of hydrogen peroxide are also effective. Scaling of the teeth to remove sub gingival calculus and plaque is also necessary to reduce the infection and prevent recurrence. Without dental prophylaxis and adequate oral hygiene, the condition settles in as a sub acute or chronic infection, with acute flare-ups during periods of stress.