OF all the diseases affecting the human race, gum disease happens to be the second most prevalent. However, this condition is not a single entity. Various kinds exist. There is a particular type of gum disease, which is often seen mainly in persons between 15 and 35 years and 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 spreading 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 greyish 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 an inability to eat due to sensitivity or intense pain in the gums. The type of pain experienced is 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 generalised 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.
Most researchers believe that trench mouth is a primary disease caused by a fusiform bacillus (rod-shaped) and a spirochete (cork-screw shaped) called borrelia vincentii. Because these two micro-organisms frequently exist in many healthy mouths, it obviously suggests that some other predisposing factor is involved in the actual case of infection.
To confirm this, scientists have never been able to induce trench mouth artificially in persons. The most important factor, which predisposes someone to contract 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.
Without a doubt, 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, instituting only superficial cleaning of the mouth in the initial stage, followed by scaling and polishing when the situation permits. Others opt for oxidising 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.