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:
3. Gingival pain and bleeding
4. Foul metallic taste
5. Halitosis
6. Enlarged, tender cervical lymph nodes
7. 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:
8. Dental examination - a gray film or pseudomembrane along the gums is indicative
9. 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:
10. Good oral hygiene
    a. Brushing teeth twice a day with fluoride toothpaste.
    b. Cleaning between teeth daily with floss.
11. Dental debridement
12. Mouth washes
13. Antibiotics -penicillin or erythromycin may be required to clear infection

14. 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

    Autorentext

    Dr. Kenneth Kee is a well-known medical doctor from Singapore who has been practicing medicine since 1972.
    He graduated from the University of Singapore and furthered his studies with a Master of Science in Health Management in 1991, followed by a Ph.D. in Healthcare Administration in 1993.
    Dr. Kee established Kee Clinic in 1974, located in the Holland Drive area of Singapore. The clinic has been a prominent feature of the community, offering general medical services for 5 decades.
    Dr Kee also served his country Singapore as a national service police Inspector at night from 1975 to 1985 while working at his clinic during the day.
    He had served as a police guard to the Woodland Petroleum Tanks at night during the Indonesian Confrontation period, took part in police rounds at night in the Beach Road area and taught First aid and emergency resuscitation to Police recruits.
    He received the Singapore Police Bicentennial 2020 Medallion on 1st March 2024 as recognition for his work in the Singapore Police.
    Even as he grew older, Dr. Kee continued to work actively in his clinic, although he eventually reduced his consultation hours.
    Beyond his medical career, Dr. Kee is also an author.
    He started writing about medical conditions in 2007, using blogs and other online platforms to share his knowledge with a broader audience.
    Over time, he published various books, many of which provide simple and accessible guides to different health conditions.
    His works include "A Family Doctor's Tale," "My Personal Singapore History," and numerous medical guides, available through platforms like Amazon.
    His books often combine his personal experiences as a family doctor with insights into Singapore's healthcare system and history.
    Dr. Kee has written extensively on health topics, contributing to both medical literature and general knowledge resources.

    Dr. Kenneth Kee has written numerous books, primarily focused on health education and personal experiences as a family doctor. Some of his notable titles include:
    "A Family Doctor's Tale"
    This book is a blend of Dr. Kee's personal experiences and his reflections on being a family doctor in Singapore. It's a great choice if you're looking for a narrative that combines both medical knowledge and human stories.
    "Specialized Medical Conditions"
    Books like "Congestive Heart Failure: Diagnosis and Treatment" focus on specific conditions, offering in-dept...