The daily educational pearl – Vincent’s Angina

Vincent’s angina or acute necrotizing ulcerative gingivitis (trench mouth)

= ulceration and necrosis of interdental papillae and gingivae

– usually caused by anaerobic organisms in patients who are immunosuppressed or have very poor oral hygiene

– can spread to involve the cheeks / lips / facial bones

DDx: herpes gingivostomatitis (usually interdental papillae not involved, more systemic symptoms)


– antibiotics – metronidazole, initially iv and then po

– chlorhexidine mouth rinses twice a day

– often need debridement

– protein-rich diet, fluids; treatment (if possible) of predisposing factors

They should be referred to / admitted under the Maxillo-facial team.