What Is ANUG? The Gum Condition That Needs Urgent Attention

If you’re experiencing severe gum pain with spontaneous bleeding, a metallic taste, or bad breath especially alongside general fatigue or fever then you may be dealing with a condition called ANUG.

Acute Necrotising Ulcerative Gingivitis (ANUG) is a serious gum infection that can progress rapidly and cause significant tissue damage if left untreated.

In this article, a dentist explains what ANUG is, who is most at risk, and when to seek urgent dental advice.

What Is ANUG?

ANUG sometimes referred to as “trench mouth” is a sudden, painful infection of the gums caused by an overgrowth of bacteria.

Unlike mild gingivitis, ANUG causes:

  • Ulceration of the gum margins

  • Necrosis (death) of soft tissue

  • Greyish-white slough on the gums

  • Spontaneous bleeding

  • A strong metallic taste and foul-smelling breath

It typically starts between the lower front teeth and can spread rapidly if not managed.

Who’s at Risk?

ANUG is more common in people who are:

  • Under high stress

  • Experiencing poor sleep

  • Smoking heavily

  • Have poor oral hygiene

  • Immunocompromised or recovering from illness

  • Malnourished or dehydrated

  • Recently unwell or run-down

It’s more commonly seen in young adults particularly students or shift workers under high pressure.

Symptoms of ANUG

Common signs include:

  • Intense gum pain often starting suddenly

  • Bleeding gums, even without brushing

  • Ulcerated, crater-like lesions between the teeth

  • Bad breath or a metallic taste

  • Red, swollen, or greyish gums

  • Difficulty eating, drinking, or swallowing

  • Fever or general malaise

Is ANUG Contagious or Dangerous?

ANUG is not contagious in the traditional sense as it’s caused by bacteria that already exist in the mouth but multiply aggressively under certain conditions.

However, it can become dangerous if the infection spreads. In rare cases, untreated ANUG can develop into necrotising periodontitis or spread into deeper facial spaces which may require hospital treatment.

When Antibiotics May Be Needed

The first line of treatment for ANUG is usually professional dental hygiene cleaning and improved oral hygiene. Pain relief and smoking cessation are also critical.

However, a dentist may consider antibiotics if:

  • The patient is systemically unwell with fever or fatigue

  • There is evidence of rapid tissue destruction

  • There’s a risk of infection spreading

  • The patient cannot tolerate immediate mechanical cleaning

  • There are contributing medical conditions such as immunosuppression

Antibiotics can be used to support but not replace proper debridement and oral hygiene.

Summary

ANUG is a painful and potentially serious gum condition that needs urgent attention. Although it’s caused by bacteria, treatment involves more than just antibiotics as it requires mechanical cleaning, excellent oral hygiene, and lifestyle support.

If you’re experiencing severe gum pain with bleeding, or ulceration then don’t delay. A dentist can assess your symptoms, confirm the diagnosis, and recommend the safest and most effective course of action.

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Wisdom Tooth Pain? Here’s When You Might Need Antibiotics