Trench Mouth


What is trench mouth?

Trench mouth is a serious gum infection. It’s a more advanced and serious form of gingivitis, a common gum disease. Trench mouth makes your gums bleed, hurt and swell. It also causes ulcers or lesions between your teeth and kills gum tissue. Trench mouth is linked to conditions and activities that affect your immune system. Without treatment, trench mouth can destroy gum tissue and then spread into nearby tissues such as your cheeks, lips or jawbones.

What is another name for trench mouth?

Trench mouth goes by many names, including Vincent stomatitis, acute necrotizing ulcerative gingivitis (ANUG) and necrotizing ulcerative periodontitis. People started using the term “trench mouth” during World War I, when soldiers living and fighting in battlefield trenches developed severe gum infections linked to poor diet, poor oral hygiene and intense psychological stress.

Is trench mouth a common condition?

Trench mouth affects about 0.5% to 11% of the population. It typically affects people age 18 to 20. Trench mouth is more common in places where people don’t have access to dental care. People who have immune system diseases, particularly human immunodeficiency virus (HIV), are at increased risk for trench mouth.

Symptoms and Causes

What causes trench mouth?

Trench mouth happens the natural bacteria in your mouth begin to multiply or overgrow, infecting your gums. Several things start this overgrowth:

  • Having HIV.
  • Having diabetes.
  • Having gingivitis previously.
  • Having gum injuries.
  • Not getting enough sleep.
  • Smoking.
  • Alcohol abuse.
  • Poor diet.
  • Poor oral hygiene

What are the symptoms of trench mouth?

People who have trench mouth may develop sudden and intense gum pain that affects one or several places on their gums. Here are other symptoms:

  • They notice ulcers or sores on their papillae, the tiny slivers of skin between their teeth.
  • There’s a yellow-white or gray membrane or film on the skin between their teeth.
  • Their gums bleed easily.
  • They have extremely bad breath.

Someone who has a serious form of trench mouth may have the following symptoms:

Diagnosis and Tests

How do healthcare providers diagnose trench mouth?

Providers diagnose trench mouth by:

  • Asking about your medical history, including issues that may affect your immune system, your diet and your overall health.
  • Asking about your dental history, including your access to dental care.
  • Checking the lymph nodes for signs of swelling.
  • Checking the inside of your mouth for infection, swelling and pasty saliva.
  • Doing blood tests to see if you have certain bacteria linked to trench mouth.

Management and Treatment

How do healthcare providers treat trench mouth?

Providers typically treat trench mouth by preventing the disease from spreading and managing any pain you may have because of the condition. They may use an ultrasonic instrument or chemicals to clean your teeth and remove any dead tissue from your gums. They may prescribe antibiotics and pain medication. Sometimes, people who have trench mouth need gum surgery to fill in any craters between their teeth.


How can I prevent trench mouth?

Good dental hygiene is the best way to prevent trench mouth. Ask your dentist how often you should floss and brush your teeth.

Trench mouth is linked to general health habits like coping with stress, getting enough sleep, eating well and not smoking.

Outlook / Prognosis

Does trench mouth go away?

Trench mouth requires treatment. It won’t go away on its own. While treatment usually cures trench mouth, there are times when treatment doesn’t work. Some common reasons for treatment failing to work include:

  • Your treatment didn’t remove the infection’s root cause.
  • There’s still some dead or diseased tissue remaining after treatment.
  • You have underlying medical issues that make it difficult to cure trench mouth.
  • You didn’t follow provider guidance regarding good dental hygiene and general good health.

Living With

How do I take care of myself after trench mouth treatment?

The most important step is following good hygiene recommendations, such as flossing daily and brushing your teeth after meals.

Trench mouth happens when your immune system is under stress. You can support your immune system by having a healthy diet, getting enough sleep and managing stress.

When should I see my healthcare provider?

If you’ve had trench mouth treatment, you should see your provider if you think your trench mouth is coming back.

What questions should I ask my healthcare provider?

Trench mouth isn’t common, so you may be surprised to learn you have a gum disease that became notorious during World War I. Here are some questions you may have:

  • What caused my trench mouth?
  • Can you cure my trench mouth?
  • Will I need gum surgery?
  • Will my trench mouth come back?
  • What can I do to keep my trench mouth from coming back?

A note from Cleveland Clinic

Trench mouth is a serious gum disease that often affects people whose immune systems are under stress or who don’t have access to good dental hygiene and care. Fortunately, healthcare providers can effectively treat trench mouth. Most people begin to feel better within days of treatment. Some people, however, may need gum surgery. You can prevent developing trench mouth by having good dental hygiene. Ask your provider what you can do to prevent trench mouth. They’ll be happy to help.

Last reviewed by a Cleveland Clinic medical professional on 07/21/2022.


  • Malek R, Gharibi A, Khlil N, et al. Necrotizing Ulcerative Gingivitis. ( Contemp Clin Dent. 2017;8(3):496-500. Accessed 7/21/2022.
  • Merck Manuals. Acute Necrotizing Ulcerative Gingivitis (ANUG) – Mouth and Dental Disorders. ( Accessed 7/21/2022.
  • Mortazavi H, Safi Y, Baharvand M, et al. Diagnostic Features of Common Oral Ulcerative Lesions: An Updated Decision Tree. ( Int J Dent. 2016;2016:7278925. Accessed 7/21/2022.

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