Oral Cavity & Throat Treatment

VINCENT’S ANGINA

It is an acute ulcerative type of tonsillitis and gingivitis. Vincent first described this disease and its organism.


History:

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”.

Spread:

Disease spread by personal contact, kissing, using unclean towels etc.

Aetiology

1. Age: Usually seen in young middle age in the third to fourth decade.

2. Low immunity due to illness.

3. Dental: Local irritative lesions in the mouth, decayed teeth.

4. Vitamin C deficiency is an important factor.

5. Environmental: More common in temperate and tropical climates than arctic regions.

Organism:

Gram negative fusiform bacillus with associated spirillum- Borrelia vincenti.


Pathology:

1. The infection usually involves one tonsil usually at its upper pole. It may spread to soft palate, gums, larynx and trachea.

2. The tonsil shows patches covered by a membrane.

3. The membrane is a pseudo membrane and is formed by necrosis of the superficial layers of the mucous membrane.

4. On removal of this pseudo membrane, an ulcerative area is exposed.

Clinical symptoms:

1. Throat pain.

2. High fever, malaise.

3. Foul breath.

4. Greyish membrane seen over tonsil.

5. Cervical lymphadenopathy.


Diagnosis:

1. Diagnosis is usually clinical.

2. Complete blood count.

3. Smear for fusospirochaetal bacteria and leukocytes.

Treatment:

1. Systemic: High antibiotics, Penicillin and its derivatives are very effective, Metronidazole can be given.

2. Local:

  • 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)

3. Isolation of the patient is useful to prevent spread of infection to surroundings.

Book Your Appointment