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World Water Day 2001: Oral health: Previous page | 1,2,3,4,5,6,7

Dental health and malnutrition

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The development of healthy normal teeth requires a well balanced diet, particularly rich in Calcium and Vitamin D. Malnutrition, to which water contributes, has a direct effect on this development. A combination of poor diet and poor oral hygiene may result in the appearance of surface damage to the teeth as young as 6-12 months of age (Milgrom et al 2000).


Noma, also known as ‘cancrum oris’ is a rare but serious oral disease related to poor diet and hygiene. The name is derived from the Greek “nomein” which means “to devour”. It is a gangrene condition that starts in the mouth as an apparently benign oral lesion and rapidly destroys both soft and hard tissues of the mouth and face. Most noma sufferers are under six years of age. It flourishes where poverty is greatest, nutrition is poorest and hygiene is neglected. The disease was not uncommon in Europe and North America in the 18th and 19th Centuries. It disappeared from these continents with social and economic development. Nowadays it is an additional health problem for disadvantaged communities, especially in the African continent. The size of the noma problem is not well documented but it is estimated, by different sources, that there may be more than 100,000 cases. Today noma is treatable, if the disease is detected and recognized at an early stage. Simple and low-cost care can be provided to stop the evolution of the gangrene and to avoid disfigurement. It requires topical antiseptics, provision of antibiotics, nutritional rehabilitation and clean drinking water.

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