Acute Necrotizing Ulcerative Gingivitis
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Acute Necrotizing Ulcerative Gingivitis

(ANUG; Trench Mouth; Vincent's Stomatitis)

En Español (Spanish Version)


Acute necrotizing ulcerative gingivitis (ANUG) is a serious infection of the gums that causes ulcers, swelling, and dead tissues in the mouth. Although a very painful condition, it can be healed with treatment.


Acute necrotizing ulcerative gingivitis is typically caused by excess bacteria in the mouth. Too much bacteria can form in the mouth from smoking , stress, lack of dental care, a virus, and poor diet.

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition. Risk factors for ANUG include:

  • Lack of dental care and overall poor dental hygiene
  • Poor diet
  • Vitamin deficiencies
  • Infections in the throat, teeth, or mouth
  • Compromised immune system
  • Smoking
  • Stress
  • Age: 35 years or younger


If you experience any of these symptoms, do not assume it is due to acute necrotizing ulcerative gingivitis. These symptoms may be caused by other health conditions. If you experience any one of them, see your dentist.

  • Pain in the gums
  • Gums that bleed easily
  • Bad taste in mouth, extremely bad breath
  • Red and swollen gums
  • Gray residue on the gums
  • Large ulcers or loss of gum tissue in between teeth
  • Fever
  • Swollen lymph nodes

Red and Swollen Gums


© 2008 Nucleus Medical Art, Inc.


Your dentist will ask about your symptoms and medical history, and perform a dental exam. The dental exam will look for:

  • Inflammation of the gums
  • Destroyed gum tissue
  • Crater-like ulcers in the gums that may harbor plaque and debris from food
  • Dental x-rays
  • Facial x-rays

Dental X-ray

Jaw x-ray teeth

© 2008 Nucleus Medical Art, Inc.


Talk with your dentist about the best treatment plan for you. Treatment options include the following:

  • Antibiotics to clear up the infection
  • Dental surgery
  • Improved diet
  • Regular dental cleanings
  • Changes in diet


To help reduce your chances of getting ANUG, take the following steps:

  • Maintain a balanced, nutritional diet.
  • Take proper care of teeth and gums.
  • See your dentist regularly.


American Academy of Periodontology

American Dental Association


Canadian Dental Association

Canadian Dental Hygienists Association


Contreras A, Falkler WA Jr, Enwonwu CO, et al. Herman herpesviridae in acute necrotizing ulcerative gingivitis in children in Nigeria. Oral Microbiol Immunol. 1997;12:259-265.

DynaMed website. Available at: .

Marquette University School of Dentistry website. Available at: .

Schreiner C, Quinn FB. Stomatitis. University of Texas Medical Branch website. Available at: .

US National Library of Medicine website. Available at: .

Last reviewed February 2008 by Laura Morris-Olson, DMD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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