124 Where There Is No Dentist 2012
7. Keep the mouth clean.
• Use a soft brush gently to clean the remaining teeth. Do this 3 times a
day for the child.
• Wipe the gums with a weak solution of hydrogen peroxide. Use cotton
gauze that is damp with the solution. Do this every 2 hours for 5 days.
• Then after 5 days, start rinsing with warm salt water, 3 cups a day.
8. Get advice on whether surgery is needed.
Unfortunately, the child will probably need surgery, to release the
scar. Without this surgery, the child will not be able to open his mouth
Send the child for medical help when the
infection is finished and the wound starts
You may also need a dentist’s help at this
time. The child’s jaws may need to be
wired. The wires are put on the healthy
teeth in a way that holds the mouth open
while the tight scar is forming. When the
wires are removed, the child will be able to
open and close his mouth to chew food.
PREVENTION of Noma:
Noma need not occur. We can prevent it. Always give special attention
to the mouth of a sick child, to be sure to keep his teeth clean.
Whenever someone is nursing or caring for a sick child, that person
should clean the child’s teeth as a normal activity. This is especially
true for a child who is weak, undernourished, and with little body water
Such a child should always:
• have his teeth carefully cleaned
each day with a soft brush.
• rinse his mouth with a warm salt
water solution (page 7), 2 times
• eat fresh fruits and vegetables,
especially the kind that have
vitamin C: guavas, oranges,
pineapples, papayas, tomatoes,
peas, and dark green leaves.