A 20-year-old male presents with severe gingival inflammation and ulceration, bad breath, and painful swallowing. He reports a recent history of fever. What are the potential causes and the next steps?
This patient's symptoms suggest a diagnosis of acute necrotizing ulcerative gingivitis (ANUG), also known as trench mouth. This is a severe bacterial infection characterized by ulceration, swelling, and sloughing off of dead tissue from the gums. Immediate treatment involves professional cleaning of the mouth, antibiotics to control the infection, and possibly pain control. The patient should also be advised to rinse with a chlorhexidine mouthwash and maintain good oral hygiene.