Where There Is No Dentist 2012 121
When a child is sick, a simple gum infection can get out of control and
spread through the cheek to the face. When that happens the condition
is called Noma or Cancrum Oris. Noma is a complication of Vincent’s
Infection of the gums (page 102).
You will usually see Noma in children. It will only
develop if these 3 things are true:
1. The child’s general resistance is low.
Usually, he is undernourished and anemic
(lacks iron). He may have tuberculosis.
2. The child has Vincent’s Infection.
3. The child has recently had a serious
illness such as measles or malaria.
Noma can also be a problem for adults living with HIV. See page 191.
The infection starts in the mouth.
Then it passes to the gums.
1. Sore mouth with itching gums.
2. Swollen, sore gums.
3. Gums bleed when eating or
when teeth are cleaned.
4. Bad breath, spits a lot.
Then it reaches the jaw.
5. Loose teeth.
6. Loose pieces of bone
around the teeth.
Finally, it affects the cheek.
7. Skin is tight with dark red
8. Black spot on the cheek
breaks open, leaving a hole
into the mouth.
9. A line separates dead
tissue from healthy tissue.