Vincent’s Angina, (Trench Mouth) A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions
By Kenneth Kee
()
About this ebook
Vincent's Angina is the non contagious infection affecting the inter-dental papillae and extending to the gums.
Vincent's angina is a pharyngeal infection with an ulcerative gingivitis caused by:
1. Borrelia vincentii - a spirochete
2. Fusiformis fusiformis - a Gram -negative bacillus
Acute ulcerative gingivitis that happens without an accompanying pharyngeal infection is termed Vincent's infection.
Acute ulcerative gingivitis was frequent in the First World War when it was known as trench mouth.
It is known as Trench Mouth because of the smell from the mouth.
This is a progressive painful infection with ulceration, swelling and sloughing off of dead tissue from the mouth and throat due to the spread of infection from the gums.
Vincent’s angina is an infection of the gingiva or the gums that rapidly progresses from inflammation to swelling, ulceration, and necrosis (tissue death).
Hence it is also called acute necrotizing ulcerative gingivostomatitis (ANUG).
The dead tissue and bacteria which grow in the lesions produce a grayish-white pseudomembrane that can be readily seen in the gums.
The causative organisms are mostly anaerobic bacteria, especially Fusobacteria and Spirochete species.
Predisposing factors are poor oral hygiene, smoking, malnutrition, psychological stress and immunosuppression (sub-optimal functioning of the immune system).
This disease, along with necrotizing (ulcerative) periodontitis (NP or NUP) is classified as a necrotizing periodontal disease, one of the seven general types of periodontitis.
The often severe gingival pain that characterizes ANUG differentiates it from the more frequent chronic periodontitis which is seldom painful.
ANUG is the acute presentation of necrotizing ulcerative gingivitis (NUG), which is the normal course the disease takes.
If not properly treated or neglected, NUG may become chronic and recurrent.
There is abrupt onset of:
1. Gingival pain and bleeding
2. Foul metallic taste
3. Halitosis
4. Enlarged, tender cervical lymph nodes
5. Fever, malaise, anorexia
Oral examination shows punched-out, ragged gingival ulceration
If the pharyngeal mucosa is also inflamed, then this indicates Vincent's angina
Vincent's Angina is diagnosed by:
1. Dental examination - a gray film or pseudomembrane along the gums is indicative
2. Buccal smear for culture and sensitivity of micro-organisms to antibiotics
Treatment
The ulcerative gingivitis in Vincent’s Angina reacts well to penicillin V 500 mg / 6h PO combined with metronidazole 400 mg / 8h PO.
Immunocompromised patients may not respond as well as those who are immunocompetent.
Treatment primarily requires pain relief and bacterial eradication.
Analgesics are given in such cases.
Also, the oral mucosa is cleaned by removing plaque and food debris by oral irrigation.
An antimicrobial mouthwash is advised and patients are asked to strictly observe oral hygiene.
In serious cases the mechanically scraping off the dead tissues (debridement) or hard deposits of tartar from the mouth is performed under local anesthesia.
Because teeth brushing are very sore during an attack, the mouth should be kept clean by the use of regular mouth washes.
The patient should be told to pay careful attention to oral hygiene after the attack in order to help prevent recurrence:
1. Good oral hygiene
a. Brushing teeth twice a day with fluoride toothpaste.
b. Cleaning between teeth daily with floss.
2. Dental debridement
3. Mouth washes
4. Antibiotics -penicillin or erythromycin may be required to clear infection
5. Avoid smoking
TABLE OF CONTENT
Introduction
Chapter 1 Vincent’s Angina
Chapter 2 Causes
Chapter 3 Symptoms
Chapter 4 Diagnosis
Chapter 5 Treatment
Chapter 6 Prognosis
Chapter 7 Gingivitis
Chapter 8 Strep Throat
Epilogue
Kenneth Kee
Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"
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Vincent’s Angina, (Trench Mouth) A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions - Kenneth Kee
Vincent’s Angina,
(Trench Mouth)
A
Simple
Guide
To
The Condition,
Diagnosis,
Treatment
And
Related Conditions
By
Dr Kenneth Kee
M.B.,B.S. (Singapore)
Ph.D (Healthcare Administration)
Copyright Kenneth Kee 2017 Smashwords Edition
Published by Kenneth Kee at Smashwords.com
Dedication
This book is dedicated
To my wife Dorothy
And my children
Carolyn, Grace
And Kelvin
This book describes Vincent’s Angina, Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.
(What The patient Need to Treat Vincent’s Angina)
This eBook is licensed for your personal enjoyment only. This eBook may not be re-sold or given away to other people. If the patient would like to share this book with another person, please purchase an additional copy for each reader.
If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.
Thank the patient for respecting the hard work of this author.
Introduction
I have been writing medical articles for my blog http://kennethkee.blogspot.com (A Simple Guide to Medical Disorder) for the benefit of my patients since 2007.
My purpose in writing these simple guides was for the health education of my patients.
Health Education was also my dissertation for my Ph.D (Healthcare Administration).
I then wrote an autobiolographical account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.com.
This autobiolographical account A Family Doctor’s Tale
was combined with my early A Simple Guide to Medical Disorders
into a new Wordpress Blog A Family Doctor’s Tale
on http://kenkee481.wordpress.com.
From which many free articles from the blog was taken and put together into 800 amazon kindle books and 200 into Smashwords.com eBooks.
Some people have complained that the simple guides are too simple.
For their information they are made simple in order to educate the patients.
The later books go into more details of medical disorders.
The first chapter