TREATMENT FOR ANUG

Treatment of Acute Necrotizing Ulcerative Gingivitis

Treatment of Acute Necrotizing Ulcerative Gingivitis attempts to stop the infection, relieve the symptoms and restore the damaged gum tissue.
Medications. Dentists often prescribe antibiotics for ANUG treatment, in order to fight the bacterial growth and prevent infection from spreading. Over-the-counter or prescription pain relievers are also recommended, especially if the patient can not brush or floss teeth because of the pain of the gums.
Patients with Acute Necrotizing Ulcerative Gingivitis are placed on tetracycline 500mg for a week before treatment.

Antibiotic therapy (preferably narrow spectrum, to leave gram-positive aerobic flora unperturbed).
Metronidazole is the drug of choice, 500 mg PO BID for 7-10 days.
If the patient cannot tolerate metronidazole: clindamycin 150 mg QID or amoxicillin-clavulanate (Augmentin) 875 mg PO BID for 7-10 days, if no hypersensitivity or allergy to either drug exists.
The type of antibiotic prescribed depends upon the exact type of the bacteria. Several antibiotics have been used to treat aggressive periodontal disease. They include:
Penicillins
Tetracyclines-HCL
Doxycycline
Metronidazole
Ciprofloxacin
Clindamycin
Professional dental cleaning. A gentle cleaning of teeth and gums by the dentist is usually the first step in the treatment of trench mouth. The dentist will also remove any dead gum tissue. As soon as the pain is reduced the dentist will perform a more thorough cleaning procedure called tooth scaling and root planing. This procedure removes dental plaque and tartar from beneath the gumline and smooths any rough surfaces of the teeth roots.

Oral hygiene. Following a proper daily oral hygiene routine is essential for the treatment of trench mouth. Teeth should be brushed gently with a soft toothbrush at least twice a day after very meal and flossed at least once a day. If the gums feel very painful for brushing, an antiseptic mouthwash may be used for a few days for the home treatment of ANUG, until the pain subsides enough to allow brushing and flossing. Salt water rinses and hydrogen peroxide mouthwashes can also help soothe the pain of sore gums.

Gum surgery. If the damage to the gums is extensive, dental cleaning and oral hygiene may not be enough to restore the gum tissues. In this case, the ANUG treatment involves gum surgery (periodontal surgery) in order to restore the normal shape of the gums.

It is recommended that during Acute Necrotizing Ulcerative Gingivitis treatment, any cause of irritation to the gums, such as smoking or eating spicy foods and drinking alcohol, should be avoided. Treatment of trench mouth with regular brushing and flossing, professional tooth cleaning and antibiotics is generally effective. In mild cases of ANUG complete healing is expected in a couple of weeks.