1st described by Jean Hyacinthe Vincent and in 1904 noted the infection was caused by infection with two types of bacteria called fusiform (Fusobacterium spp.) and spirochaetes (Borrelia spp. and Spirillum spp.) (which also cause his Vincent's angina - fusospirochaetal infection of the pharynx and tonsils )
during WWI was called trench mouth
mainly occurs in young adults in Western countries, whereas it is more common in children in Third World countries
Risk factors
immunocompromise
poor oral hygiene
smoking
poor nutrition
psychological stress (eg. in trenches of WWI and even in civilians with good nutrition but exposed to stress of bombing raids)
following acute viral infections in children eg. measles
Clinical features
ulceronecrotic infection of the gums which is sudden onset and more painful than common gingivitis or periodontitis
profuse gum bleeding with little or no provocation
ulcerated, necriotic interdental papillae
may progress to necrotising periodontitis - infection leads to attachment loss, and involves only the gingiva, periodontal ligament and alveolar ligament
rarely, without Rx, it may progress to cancrum oris (Noma) with spreading gangrene to the facial tissues - usually in children in Third World countries
DDx
common gingivitis - not as painful, no necrosis or ulceration
primary Herpes simplex virus (HSV) gingivostomatitis - no necrosis just inflammation with painful ulcers which often also involve the tongue and usually present with fever and enlarged Cx LNs