THE  bad news is that chronic gum disease, also called chronic periodontitis, cannot be cured, although most of the symptoms may disappear for months after treatment. This condition is generally only controlled by dentists and patients. The disease develops from simple gingivitis, which is believed to occur in everyone from time to time. The key is not to allow it to worsen, which can ultimately lead to chronic gum disease.

Of all the diseases affecting humanity, gum disease is the second most prevalent. However, this condition is not a single entity—various kinds exist. Fortunately, most people get the relatively mild form. However, there is a special type of gum disease, which is often seen mainly in people 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. Sometimes called trench mouth, the pattern of spreading on many occasions indicates that it is contagious, although some authorities do not accept this. In any case, its occurrence in groups of people 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 papillae (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 sensitive or intense pain in the gums. The type of pain experienced is a superficial ‘pressure’. Typically, the patient experiences headaches, malaise, and a low-grade fever (37.2 to 39 degrees Celsius).

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 papillae, 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 at any time in the future.

Many researchers believe that trench mouth is a primary disease caused by a fusiform bacillus (rod-shaped) together with a spirochaete (corkscrew-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 people. 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. World War researchers who studied the epidemic that 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 varies significantly depending on the dentist’s experience 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 include oral gangrene, septicaemia, toxaemia (blood poisoning), and even death itself.