When to Seek Medical Care

For simple gingivitis, work with your dentist. A concerted effort between good home dental hygiene and regular dental visits should be all that is required to treat and prevent gingivitis. If gingivitis continues despite the effort to prevent it, contact your doctor to investigate the possibility of an underlying illness.

Gingivitis can usually be managed at home with good dental hygiene. If gingivitis turns into the most severe periodontal infection, acute necrotizing ulcerative gingivitis (ANUG), commonly referred to as trench mouth, treatment at a hospital may be required.

• ANUG not only affects the gums but may spread to adjacent tissues of the face, neck, and bone. Bleeding, loss of periodontal architecture, and pain all characterize ANUG. The breath takes on a fetid odor, the teeth become loose, and the lymph nodes of the neck are often swollen. People with ANUG often have fever and complain of a generalized weakness reflecting widespread infection.

• Like gingivitis, ANUG usually affects people with underlying immune system situations such as malnutrition, HIV, or cancer. Therapy involves getting rid of the oral bacteria with antibacterial mouthwashes, oral antibiotics, periodontal treatment, and treatment of the underlying illness.