Acute Ulcerative Gingivitis – A Painful Gum Problem

Acute necrotizing ulcerative gingivitis, ANUG (sometimes just called AUG), is a form of gum disease (more here).  It is easily recognizable in that it usually develops quickly and causes pain in the gums.  Most other gum diseases do not flare up as quickly as AUG does.

“Necrotizing” means that gingival tissue is destroyed by the condition. “Ulcerative” refers to sores that can appear on the gums.

The condition has many different names and classifications, including:

  • Acute Ulcerative Gingivitis (AUG or just NUG)
  • Vincent’s angina
  • Trench mouth
Acute necrotizing gingivitis on lower teeth

The appearance of the gums around the lower front teeth is classical of ANUG


Common Symptoms

The symptoms of acute ulcerative gingivitis may include:

  • Painful gums.  The pain can be severe. The lower incisors are most commonly affected most severely.
  • Red, bleeding, swollen gums.
  • Halitosis/ bad taste which again can be severe. These symptoms are caused by the by-products of the bacteria that eat the gingival tissues – Not pleasant!
  • Ulcers on the gums.
  • The gums appear gray and rotting away, especially between the teeth (see photo).
  • Sometimes you may feel generally unwell, with a sore throat, fever and raised glands of the neck.


Causes of the problem

It is caused by rapid proliferation of a range of particular microorganisms, that seem to thrive in conditions of poor plaque control.

Typically, this occurs in younger patients, in their late teens and twenties.  There are several factors that can be classed as acute ulcerative gingivitis causes:

  • Stress is a major factor.  For example the problem occurs frequently in students at exam time.
  • Smoking is a major cause of AUG (and of gum disease in general).

    Smoking is a major risk factor

  • Plaque build-up as a result of poor oral hygiene.
  • A poor and unbalanced diet, with not enough vitamins and minerals.
  • Being run-down in general; ‘burning the candle at both ends’.
  • Other medical infections such as a ‘flu.
  • A low immune system and sub-standard living conditions.


Acute Ulcerative Gingivitis Treatment

Of course, prevention is better than cure.  By looking after your teeth and gums, as well as your general health, you will reduce the chances of getting this problem.  Smoking should also be cut down on and ideally cut out.

If you think you have ANUG, attend your dentist.  Your dentist will clean the affected areas and then instruct you on how to look after the gums.  Treatment may include mouthwashes (more info here) and antibiotics.  You will need to avoid smoking and alcohol.

Follow-up visits will be necessary to ensure good gum healing and reducing the chances of the infection recurring.



If you get this unpleasant infection, you are at high risk of developing it again. In order to reduce your chances of doing so:

  • Brush, floss and use a mouthwash. Plaque must be kept at bay! Read our complete guide to dental hygiene starting here.
  • Quit smoking if you do so
  • Make sure you eat a balanced diet.


Leave a Reply

Your email address will not be published. Required fields are marked *


Scroll To Top