necrotizing ulcerative gingivitis (NUG), an inflammatory destructive disease of the gingivae that has a sudden onset with periods of remission and exacerbation. It is usually associated with poor oral hygiene, immunosuppression, smoking, local trauma, poor nutritional status, inadequate sleep, or recent illness and psychological stress. It is most common in conditions in which there is crowding of the teeth and malnutrition. Also called Vincent’s angina, Vincent’s infection, trench mouth. ▪ OBSERVATIONS: It is marked by ulcers of the gingival papillae that become covered by sloughed, necrotic tissue and circumscribed by linear erythema. Foul-smelling breath, increased salivation, bone destruction, lymphadenopathy, and spontaneous gingival hemorrhage are additional features. It may extend to other parts of the oral mucosa, with lesions involving the palate or pharynx. ▪ INTERVENTIONS: Treatment includes chlorhexidine, warm saltwater rinses, mouthwashes, antibiotics, analgesics, and dental care to remove and disrupt bacterial flora. ▪ PATIENT CARE CONSIDERATIONS: During World War I, this disease was nicknamed trench mouth. Although the disease often occurs in an epidemic pattern, it has not been shown to be contagious
