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Trench mouth, as it occurred especially in World War I in soldiers, is a necrotizing ulcerative gingivitis (NUG) in people who have poor oral hygiene, malnutrition, vitamin deficiency, a smoking history, and psychic stress. When not treated properly, this condition can lead to noma. NUG and noma are mainly seen today in severely malnourished, poorly cared for, and immunocompromised children in extremely poor living conditions, mainly in sub-Saharan Africa. In 20th century history, the occurrence of noma in Turkey was described by Albert Eckstein (1891-1959), but noma is particularly linked to the atrocious living conditions in the Nazi exterminations camps, such as Auschwitz, where large numbers of patients with noma were treated in Berthold Epstein's (1890-1962) Noma Department in the Zigeunerlager (Gypsy Camp) under the supervision of SS physician Josef Mengele (1911-1979). Although these patients were treated successfully, all of them, mostly children, were ultimately killed. The protocols of the noma research are lost, and descriptions from Auschwitz are scarce. Fortuitously, there are some testimonies, especially from postwar trials, that give insight on this ambiguous and repressed topic.

Vincent's infection is a progressive painful infection with ulceration, swelling, and sloughing of the dead tissue from the oral cavity and oropharynx caused by the fusiform bacillus (Fusobacterium fusiforme) and spirochetes (Borrelia vincentii). However, it is rare in the vocal cords. We present a case of Vincent's angina of the larynx in an otherwise immunocompetent patient. This case report is to highlight clinician's diagnostic challenge, the need for crucial interdisciplinary interaction with microbiologist, and the significance of “urgent smear” (which is most often overlooked) for timely curative patient care.

Background of the study : Many health problems of the mouth, such as oral thrush, trench mouth, bad breath and others are considered as effect of poor dental hygiene. Most of these dental and mouth problems may be avoided just by maintaining good oral hygiene. Objectives of the study : To assess the oral health status and self-reported oral hygienic practices among school children to find the correlation and association between oral health status and self-reported oral hygienic practices Material and methods : The research design adopted for the study was descriptive co-relation research design. The study was conducted in selected schools at Mangaluru. The samples comprised of 100 school children studying in 5 th to 7 th standard who were selected using convenient sampling technique. Demographic proforma, oral health assessment tools and self reported oral hygienic checklist were used to collect the data. Descriptive and inferential statistics were adopted to analyze the data. Result : The study revealed that majority [45%] of the samples had unhealthy oral health status, [41%] had observed changes in the oral cavity and [14%] of the samples belongs to healthy category. The self reported oral hygienic practices among samples were [47%] of the sample having poor oral hygienic practice, [42%] of the samples having satisfactory oral hygienic practice and [11%] of the samples had good oral hygienic practices. Conclusion : From the present study, it was found that majority of the school children were suffering from dental problems such as dental caries, gum diseases and dental pain .Hence these students were referred to Yenepoya Dental College Hospital for the further management.

Oral malodour (halitosis) is common; most people have some element of transient unpleasant oral odour at some time.1 w1 In the developed world, 8-50% of people perceive that they have persistent recurrent episodes of oral malodour. This article provides a succinct review of oral malodour relevant to medical practitioners. Oral malodour is common and can affect people of all ages. When severe or longstanding, it may decrease self confidence and social interactions.w2 Oral malodour on awakening is common and generally not regarded as halitosis. Longstanding oral malodour is usually caused by oral, or sometimes nasopharyngeal, disease (box 1). The most likely cause of oral malodour is the accumulation of food debris and dental bacterial plaque on the teeth and tongue, resulting from poor oral hygiene and resultant gingival (gingivitis) and periodontal (gingivitis/periodontitis) inflammation. Although most types of gingivitis and periodontitis can give rise to malodour, acute necrotising ulcerative gingivitis (Vincent's disease, trench mouth) causes the most notable halitosis. Adult periodontitis, characterised by gradual plaque related loss of periodontal attachment, can cause variable degrees of oral malodour.2 Aggressive periodontitis, typified by rapid loss of periodontal bone and resultant tooth mobility, can cause intense oral malodour. Lack of oral cleansing because of xerostomia (dryness of the mouth) also has the potential to cause or enhance malodour,w3 and some evidence indicates that wearing dentures may sometimes cause oral malodour, possibly by virtue of increased tongue coat deposits.w4 Mild transient oral malodour often arises after sleep and is sometimes termed “morning halitosis.” This may be more likely in people with nasal obstruction—for example, due to upper respiratory tract infection—or when people sleep in a hot, dry atmosphere. Transient oral malodour can also arise after someone has eaten volatile foods such as garlic, onions, or spices (durian is reputed to …

Many years ago attention was called to bruxism and its seriousness was empha­ sized by researchers in the field. The con­ dition is far more prevalent than many realize, and research is being carried on constantly to determine the extent o f this disorder. Much valuable new data are available as a result of findings relating to service men and women both in and out of veterans hospitals. Hundreds o f veterans have been ob­ served and each case provides a definite history of some form of bruxism. The origin of the condition can be traced to widely different causes from battle fatigue to home surroundings, from marital troubles to rehabilitation— but symptoms in the oral cavity are the same in all of them. Unfortunately, the diagnoses are as varied as the origin. These conditions are being diagnosed as Vincent’s infection, Vincent’s angina, trench mouth, gingivitis — all of the common disorders— and are being treated on the supposition that de­ struction of the organisms will clear up the disorder. W e have demonstrated, as have many others, that this theory of medicinal application and oral hygiene is unsuccessful. The patient shown in Fig­ ure 1 was treated for periodic gingival disorders. The condition recurred. Care­ ful checking of his history revealed brux­ ism to be the cause o f the disturbances. In a significant number o f cases all inflammatory gingival areas have been re­ moved, but there is a recurrence in a short time. Conservative curettage, with interden­ tal stimulation and continual polishing o f root surfaces as applied to all gingival inflammatory cases, is o f little help when the patient continues a persistent trau­ matizing of tissues and bone.

Summary A case of membranous stomatitis is described. Smears made from the lesion showed a preponderance of streptococci, and cultures yielded chiefly Streptococcus viridans and a few colonies of Staphylococcus aureus . The condition had been wrongly diagnosed as trench mouth, and treatment directed toward the cure of this condition was of no value. An aqueous solution of brilliant green produced a rapid cure.

T HOMAS L. GILMERl in 1901, in lectures to the Senior Class at North western University, discussed involvement of partially erupted third molars. “Many lower third molars cause trouble from the fact that they do not fully erupt. Its antagonist may be fully erupted; mastication bruises the gum and this with sept.ic matter under the operculum causes very painful and sometimes dangerous conditions. The inflammation may subside, only to return at a subsequent time. In these cases,‘if I value the tooth, I consider it good practice to cut away the operculum of gum after the inflammation is under control. To control this I wash out the pus and other material contained in the pocket with pyrozone. If there is much pain, I take the crystals of muriate cocaine and grind them in 95 per cent solution of carbolic acid, and apply a small quantity of this under t,he operculum; this gradually relieves the pain. If it does not, I use hot water externally and if necessary, anodynes internally. “Some texts teach removal of the second molar, thereby permitting the third molar to move forward and gain sufficient room for eruption. This may be expedient in some cases, but if it were possible I should prefer the removal of the third molar. ” It was a few years later that Gilmer described a disease of the gums which he termed “acute ulcerous gingivitis,” which has since been discussed very widely and under many names, such a,s, “trench mouth,” “ulceromembranous gingivitis, ’ ’ and “ Vincent ‘s gingivitis. ’ ’ Soon after publishing a description of the disease and outlining his treatment, the bacteriologic studies made at Gilmer’s suggestion by Weaver and Tunicliff established the fact that the fusiform bacillus and associated spirochetes were the active organisms. These organisms had been previously described by Plaut and Vincent in 1896 and 1898, but their presence in gingival infection had not been specifically mentioned. Most writers on the subject of Vincent’s infection of the mouth agree that (1) Vincent’s infection may be found in and about the soft tissue flaps of unerupted or partially erupted teeth, (2) when Vincent’s infection is present it is caused by the fusiform bacillus and Vincent’s spirillum, (3) the use of oxidizing drugs in general is a desirable method of treatment. Miller2 suggests that the primary incubation zones are gingival flaps about partly erupted lower third molars. Zemsky” states that there are many ideal environments in the mouth for the growth of Vincent’s organisms, such as deep gingival crevices and pockets around partly erupted teeth. Disraeli4 includes tissue flaps covering unerupted teeth as areas of lowered resistance favorable to the development of Vincent’s infection. The many references to infection about the overlying gum flap of unerupted and partially erupted teeth indicates that these infections are common

Fusiform bacilli and spirilla are so universally found in the morbid tissues of noma, hospital gangrene, Vincent's angina, gangrenous balanitis, and other phagadenic processes 1 that, in the light of our present knowledge, most writers believe that we are justified in considering them as the possible if not the probable causative agent in these processes. Gins 2 records the finding of bacilli identical with B. fusiformis in the intestines of lower animals, and Warthin 3 mentions finding these bacilli in the intestinal discharges of a dog affected with dysentery. We have not found, however, any previous report of a typical noma, containing these organisms, in a dog. In a number of instances epidemics of noma have been reported as following outbreaks of other infectious diseases in institutional homes and hospitals for children.4 Some years ago one of us saw an extensive epidemic of this kind in the diphtheria wards of the Municipal Hospital of Philadelphia, following an epidemic of measles. During the late war Campbell and Dyas5 reported epidemics of an ulcerative condition of the mouth and throat, called "trench mouth," in which spirilla and fusiform bacilli were found in the lesions. Warthin3 states, "Vincent's angina is regarded as directly and indirectly contagious within rather narrow limits. The affection often involves definite groups of students living in close association. A similar group-infection of nurses and hospital attendants has been observed." Such epidemics would suggest the possibility of these organisms becoming so exalted in virulence under certain conditions as to be more or less highly contagious. In fact Barker and Miller 6 state "there is positive evidence both as to the infectiousness and the

Publisher Summary This chapter discusses the techniques for monitoring the oral circulation in humans and the effects of local anesthetics and vasoconstrictors upon the vascular responses. It illustrates a typical recording of the blood flow as indicated by changes in the amplitude of the blood volume pulse (BVP) of the gingival papilla, recorded simultaneously with digital BVP and other physiological variables. The chapter describes the parameters in response to a standard physiological stress, such as the cold pressor test for 21 subjects. During cold pressor stimulation, apparent vasoconstriction of both papilla and finger is associated with decreased propagation time and increased crest time. This technique has been utilized to differentiate patients with oral disease, such as acute necrotizing ulcerative gingivitis or trench mouth from healthy controls. The chapter discusses monitoring of the circulation of the periodontal ligament by insertion of the probe through root canals.

Many common psychosomatic syndromes other than peptic ulcer and ulcerative colitis are referable to the gastrointestinal tract. Symptoms range from pain or polyphagia to teeth grinding or trench mouth. A multifactor concept of the influence of stress emphasizes the interactions of the behavioral and biologic states of the organism in producing physical symptoms and signs of illness.

Extract Ulcero-membranous gingivitis, commonly referred to as Vincent's Angina, or Trench Mouth, is a not uncommon condition in human beings but we can find no references in the literature to the condition being recorded as such in domestic animals. The purpose of this communication is to record what is believed to be this condition in sheep.

An attack of "trench mouth," or acute necrotizing ulcerative gingivitis (ANUG), has been associated with emotional disorders and high levels of psychosocial stress for some time. Now a new study not only pinpoints some of the resulting immunologic and endocrine dysfunctions but shows, rather surprisingly, that the condition affects many more whites than blacks. One hundred ANUG patients referred to the periodontal clinic were the volunteer subjects of a three-year study carried out by Ronald B. Cogen, DDS, PhD, associate professor of dentistry, University of Alabama School of Dentistry, Birmingham, and coinvestigators Alvin W. Stevens, Jr, DMD, associate professor of dentistry, and Steven A. Cohen-Cole, MD, associate professor of psychiatry at the university's medical school. Like ANUG patients in general, these patients were relatively young, ranging in age from 14 to 35 years with a mean of 23.9 years. Males constituted 40% of the group. In contrast to the general

Acute diseases of the mouth are more common in infants and children than in adults. Most prevalent in the neonatal period, thrush is seldom seen after the teeth begin to erupt. During the second year another oral disease, characterized primarily by intense inflammation of the gums, oral fetor, fever and acute swelling of the regional lymph nodes, begins to appear with rapidly increasing frequency, reaching a peak in the third year, when it becomes the commonest of the acute diseases of the mouth which occur at any age. The purpose of this paper is to report the results of a clinical and microscopic study of 69 cases of this disease, which is variously known as Vincent's stomatitis, Vincent's angina, ulcerative or ulceromembranous stomatitis, necrotic stomatitis, fusospirochetal stomatitis, aphthous or aphthoulcerative stomatitis, trench mouth, etc. There are in all over thirty synonyms.1 This study was undertaken originally at the suggestion

During the four months, October, 1916, to February, 1917, 129 cases of this hitherto rare condition have passed through our hands. In this article we endeavor to give the results of our routine, laboratory and ward observations, which though incomplete may be of value in Canada and the United States after the conclusion of the present conflict, whither doubtless the infection will be carried by the returning troops. Until the beginning of the war, it was in Europe one of the rarest diseases, and in America practically unknown, at least so far as medical literature was concerned. It seems to have first become prevalent in France, where it was known as trench mouth, and believed to be caused by overindulgence in cigarets, etc. Now, however, it is so prevalent that it may be classed as among the commonest of disabilities among the troops. As usually seen the condition is not

Before trench warfare in France, in 1914, Vincent's angina was well recorded in the literature as a form of sore mouth. The organisms that cause the oral infection had been described, but a specific therapeutic agent had not been discovered. Apparently, it was a rare disease. Very few members of the medical profession and even fewer members of the dental profession were familiar with it. In France, during the war, trench mouth was more common than were typhoid and malaria during the Spanish war, and the dentists in the medical corps of the army very quickly recognized it. In addition, they soon found that sodium perborate was a specific. Many other chemotherapeutic agents were employed, including the aniline dyes and some forms of arsphenamine intravenously. When Dr. Norval H. MacDonald, a member of the dental corps of the army, returned from France, in 1919, he gave me a clear description

Those who were in the service during the recent war and particularly those who served in any one of the fields of battle will recall the disease which was more or less prevalent among the rank and file and which was popularly known as trench mouth. The condition was not serious in that it did not impair the man's fighting efficiency, but it was annoying because of its contagiousness and its resistance to treatment. The frequency with which this condition has been encountered during the last two years among the children of this city has excited no little comment. It is designated by several names: suppurative gingivitis, Vincent's angina, trench mouth and ulcerative stomatitis. The latter term has been used, however, to describe two conditions which, I believe, are not identical either etiologically or clinically, but which frequently coexist in the same patient. The terms Vincent's angina, trench mouth and

Fusospirillosis is a specific infectious disease, characterized by a local ulceration and pseudomembranous exudate, usually on a mucous membrane, and by constitutional symptoms due to toxins produced at the site of the lesion. 1 The widespread pathogenesis of the organisms is well known. The usual disorders are the classic Vincent's angina, ulcerative stomatitis and balanitis gangrenosa. The organisms have been found in cases of noma, vulvitis, vaginitis, pelvic peritonitis and hospital gangrene. Pulmonary abscesses, particularly following tonsil-lectomy, have been shown to contain these organisms. Reports of wound infection, particularly those wounds caused by human bite, are not common. Hultgen 2 describes the condition occurring in a child who suffered from partial gangrene of one of the index fingers as the result of infection with spirochetes and fusiform bacilli, attributed to her habit of biting her nails with carious teeth. Peters 3 reports two cases of the infection

Vincent's infection may present itself in the mouth and pharynx as Vincent's angina or the more common condition, which has come to be known as trench mouth, or the two may be present together. It is an acute infectious disease, presumably due to the combined action of a spirochete and a fusiform bacillus. It is characterized clinically by inflammation and the formation of ulcerative lesions of greater or less magnitude located primarily on the mucous membrane of the gums, cheeks, uvula, tongue or tonsil; a variable degree of necrosis of the mucous membrane and contiguous tissues; the formation of a grayish membrane at the site of the lesion or lesions; constitutional disturbances varying with the severity of the infection, and enlargement of the adjacent lymph nodes. Two clinical types are to be observed. The milder and more common form is slower in its progress, remains on the surface and does