Trench mouth medical therapy
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Farwa Haideri [2]
Overview
Supportive therapy for trench mouth includes analgesics and either salt water or hydrogen peroxide-based rinses. Antimicrobial therapy is indicated among patients with signs of systemic involvement.
Medical therapy
Treatment options include irrigation and debridement of necrotic areas (areas of dead and/or dying gum tissue), oral hygiene instruction and the uses of mouth rinses and pain medication. If there is systemic involvement, then oral antibiotics may be given, such as Metronidazole or Chlorhexidine. As these diseases are often associated with systemic medical issues, proper management of the systemic disorders is appropriate. The simple reduction of bacteria, through improved oral cleaning and salt water, or hydrogen peroxide-based rinses can also be implemented.[1]
The goals of treatment are to cure the infection and relieve symptoms. A healthcare provider can also prescribe antibiotics if symptoms of a fever are present. Good oral hygiene is vital to the treatment. Brushing and flossing teeth thoroughly as often as possible, at least twice a day, is preferable. Salt water rinses may soothe sore gums. Hydrogen peroxide, used to rinse the gums, is often recommended to remove dead or dying gum tissue. Rinses at hourly intervals with warm normal saline or twice/day with 1.5% hydrogen peroxide or 0.12% chlorhexidine may help during the first few days after initial debridement.[2] Over-the-counter pain relievers (analgesics) may reduce discomfort. Soothing rinses or coating agents may reduce pain, especially before eating. Application of lidocaine to the gums for severe pain is also an option.[3]
Antimicrobial regimen
For any signs of systemic involvement, the recommended antibiotics that can provide rapid relief include:
- Amoxicillin, 250 mg 3x daily for 7 days ± Metronidazole, 250 mg 3x daily for 7 days
If debridement is delayed:[2]
- Amoxicillin 500 mg every 8 hours for 3 days
- Erythromycin 250 mg every 6 hours for 3 days
- Tetracycline 250 mg every 6 hours for 3 days
References
- ↑ "Parameter on acute periodontal diseases. American Academy of Periodontology". J. Periodontol. 71 (5 Suppl): 863–6. 2000. doi:10.1902/jop.2000.71.5-S.863. PMID 10875694.
- ↑ 2.0 2.1 "Acute Necrotizing Ulcerative Gingivitis (ANUG) - Dental Disorders - Merck Manuals Professional Edition". Retrieved October 25, 2016.
- ↑ "Managing Patients with Necrotizing Ulcerative Gingivitis".