(Trench Mouth, Vincent Angina) Necrotizing ulcerative gingivitis, often caused by an infection with both spirochetes and fusiform bacilli, is common in young adults under stress (classically in students at examination time) Underlying systemic diseases may also predispose to this disorder Clinically, there is painful acute gingival inflammation and necrosis, often with bleeding, halitosis, fever, and cervical lymphadenopathy Warm half strength peroxide rinses and oral penicillin (250 mg three times daily for 10 days) may help Dental gingival curettage may prove necessary