It is an acute ulcerative type of tonsillitis and gingivitis. Vincent first described this disease and its organism.
Necrotizing ulcerative gingivitis has been observed for centuries. Jean Hyacinthe Vincent, a French physician working at the Paris Pasteur Institute describes a fusospirochetal infection of the pharynx and palatine tonsils, causing “ulcero-membranous pharyngitis and tonsillitis”, which later became known as Vincent’s angina. Later in 1904, Vincent describes the same pathogenic organisms in “ulceronecrotic gingivitis”.
- Age: Usually seen in young middle age in the third to fourth decade.
- Low immunity due to illness.
- Dental: Local irritative lesions in the mouth, decayed teeth.
- Vitamin C deficiency is an important factor.
- Environmental: More common in temperate and tropical climates than arctic regions.
Disease spread by personal contact, kissing, using unclean towels etc.
Gram negative fusiform bacillus with associated spirillum- Borrelia vincenti.
- The infection usually involves one tonsil usually at its upper pole. It may spread to soft palate, gums, larynx and trachea.
- The tonsil shows patches covered by a membrane.
- The membrane is a pseudo membrane and is formed by necrosis of the superficial layers of the mucous membrane.
- On removal of this pseudo membrane, an ulcerative area is exposed.
- Throat pain.
- High fever, malaise.
- Foul breath.
- Greyish membrane seen over tonsil.
- Cervical lymphadenopathy.
- Diagnosis is usually clinical.
- Complete blood count.
- Smear for fusospirochaetal bacteria and leukocytes.
- Systemic: High antibiotics, Penicillin and its derivatives are very effective, Metronidazole can be given.
- Sodium perborate paste is spread over the ulcer. This releases oxygen and controls the growth of organisms.
- Hydrogen peroxide gargles.
- Irrigation and debridement of necrotic areas (areas of dead and/or dying gum tissue).
- Isolation of the patient is useful to prevent spread of infection to surroundings.