Noma, or cancrum oris, is a fast-acting gangrene infection that destroys the mucus membranes of the oral and facial tissues. The exact etiology of it is unknown, but it most often occurs in malnourished children living in areas with poor sanitation.
Noma has not been widely reported in the LAC region, but approximately 140,000 new cases are diagnosed annually. Mortality rate is about 8.5%. It is most prevalent in sub-saharan Africa.
This section has information on the disease, worldwide prevalence, and links for more information:
Introduction and Fact Sheets
Noma in the World (44.66 kB)
WHO. Map showing global incidence of NOMA by percent of population effected.
Scientific and Technical PublicationsNoma in Loas: Stigma of Severe Poverty in Rural Asia
The American Society of Tropical Medicine and Hygiene, 2008. Description of clinical and social features of Noma in Laos emphasizing the significance of poverty reduction, nutritional improvement, increasing awareness and advantages of early therapy.
Epidemiology of the Incidence of Oro-Facial Noma: A Study of Cases in Dakar, Senegal, 1981-1993
The American Society of Tropical Medicine and Hygiene, 1999. Thirteen-year retrospective study based on clinical records of oral gangrene occurring in early childhood in extremely poor areas in an attempt to understand the epidemiology of noma.
No Noma (French)
International Noma Federation.
Winds of Hope
The Swiss foundation "Winds of Hope" is making its first donation to WHO to help African children facing the threat of the deadly Noma disease.
University of Maryland Medical Center
Overview, Symptons, Treatment, Prevention.
Noma, Facing of Africa
A UK NGO devoted to Noma.
Secure our Children
The Secure Our Children Foundation is an action-focused organization with the broad mission of containing hunger and malnutrition, the two prime enablers of infections and diseases among poverty-stricken children in Africa.
Sources - Database:
General Health Sicience: LILACS, MEDLINE /International Agencies: PAHO- Pan American Health Organization, WHOLIS - World Health Organization / Cochrane Library: Cochrane systematic reiews, Protocols of Cochrane systematic reviews, CENTRAL, Abstracts by INAHTA, economic studies and critically appraised, abstracts of quality assessments / BBO -Brazilian Dentistry Bibliography / MEDCARIB - Caribbean Health Sciences Literature / Bandolier / Ibero-American Clinical Trials, Evidence. Updating in ambulatory, Reports / HIL- Internet Resources.
HIV/AIDS has infected millions of people worldwide. It is the most devastating illness of our time with respect to loss of human life and its associated social and economic costs.
The oral cavity plays a key role in the HIV/AIDS epidemic. It is often the first clinical sign of the disease and usually the most common complaint of those suffering from the illness. Approximately 40 varying oral manifestations of the disease have been reported since the start of the AIDS epidemic.
This section provides information on oral health care, existing dental programs, strategies and interventions for People Living with HIV/AIDS (PLWHA):
Introduction and Fact Sheets
Oral health and communicable diseases: HIV/AIDS
Oral Lesions in Infection with Human Immunodeficiency Virus (649,4 kB)
WHO, 2005. Discussion on the importance of oral lesions as indicators of HIV and as predictors of progression of HIV disease to AIDS.
Policy for Prevention of Oral Manifestations in HIV/AIDS: The Approach of the WHO Global Oral Health (495.29 kB)
WHO, 2006. Overview of global AIDS epidemic including discussion of health systems and policy. Includes information on the relationship between AIDS and oral health with recommendations for prevention and capacity building.
Scientific and Technical Publications
Oral Healthcare for People with HIV Infection
AIDS Institute & New York State Department of Public Health, 2001. Diagnosis and management of soft-tissue lesions, clinical manifestations and management of HIV-related periodontal disease, oral and maxillofacial surgery, ethical and legal considerations, oral health management in children and adolescents with HIV.
El VIH/SIDA y Otras Infecciones en la Práctica de la Odontoestomatología (7.54 MB)
OPS & ONUSIDA, 2002. Aspectos generales y diagnóstico del VIH, manifestaciones orales y su tratamiento.
Training Materials Guidelines for the Use of Antiretroviral Agents in Pediatric HIV Patients
NIH, 2008. Diagnosis, lab monitoring, treatment recommendations, monitoring antiretroviral therapy and drug resisting testing.
Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents
Office of AIDS Research Advisory Council (OARAC), 2008. Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents.
Guidance on Provider-Initiated HIV Testing and Counseling in Health Facilities (2.65 MB)
WHO & UNAIDS, 2007. Recommendations for provider-initiated testing and counseling in different types of HIV epidemics including information on social, policy and legal framework, informed consent and special consideration for various subgroups.
A Guide for Epidemiological Studies of Oral Health Manifestations of HIV (1.16 MB)
WHO, 1993. A guide intended for oral health practitioners who are not specialists in epidemoiology and for epidemiologists who are interested in HIV-associated oral lesions.
Water fluoridation is considered one of the most successful public
health interventions of the 20th century and salt fluoridation has
proven to be a cost-effective method for reducing caries in the Latin
America and Caribbean Regions. The introduction of systemic and topical fluorides have drastically reduced the rate of dental decay worldwide.
This section offers information on fluoridation facts, national programs, varying modalities of fluoride use, as well as information about the practice of adding fluoride compounds to water,
salt, etc. with the intended purpose of reducing tooth decay in the
Introduction and Fact Sheets
Statements from Six Leading Health Authorities Regarding Community Water Fluoridation (31.4 kB)
Statements from ADA, CDC, AMA, U.S. Surgeon General, National Institute of Dental & Craniofacial Research (NIDCR), and WHO.
Recommendations for Using Fluoride to Prevent and Control Dental Caries in the United States
CDC Morbidity and Mortality Weekly Report, 2001. Guide for dental and other health-care providers, public health officials, policy makers, and the public in the use of fluoride to achieve maximum protection against dental caries while using resources efficiently and reducing the likelihood of enamel fluorosis.
Scientific and Technical Publications
Promoting Oral Health: The Use of Salt Fluoridation to Prevent Dental Caries (1.21 MB)
PAHO, 2006. Introduction to book including salt fluoridation fact sheet, preface, press release and information about ordering a copy.
Promoción de la Salud Bucodental: El Uso de la Fluoruración de la Sal para Prevenir la caries dental (8.14 MB)
PAHO, 2005. Historia y ejemplo de éxito de experimentos, progreso en la Región, recomendaciones para educar comunidades sobre la fluoruración de la sal, métodos de producción y marketing de la sal y planificación estratégica para implementación de la fluoruración de la sal.
Promoting Oral Health: The Use of Salt Fluoridation to Prevent Dental Caries (7.35 MB)
Multi-Year Plan for Salt Fluoridation Programs in the Region of the Americas (Belize, Bolivia, Dominican Republic, Honduras, Nicaragua, Panama, Paraguay, Venezuela) (4.89 MB)
PAHO, 2005. History and success stories of early experiments, progress in the Region, recommendations for educating communities about salt fluoridation programs, salt production methods and processing, marketing and strategic planning for salt fluoridation implementation.
PAHO, 2000. Final Report to the W.K. Kellogg Foundation Project #43225. Program description, methodology for baseline studies, training in fluoridation techniques and quality assurance, surveillance systems and monitoring of salt fluoridation programs, general policy recommendations and legal framework.
Populations Receiving Optimally Fluoridated Public Drinking Water – United States, 1992-2006
CDC Morbidity and Mortality Weekly Report, 2008. Updated report on increasing fluoridation in the United States and progress toward Healthy People 2010 objective in the US.
Fluoride in Drinking-water (1.03 MB)
WHO, 2006. Report on sources of fluoride, health effects, guidelines and standards, analytic methods, country data and indices of severity of dental fluorosis.
Fluoride in Drinking Water: A Scientific Review of EPA’s Standards
The National Academies, March 2006. A review of studies conducted in the last 10 years that warns against over-fluoridation.
Nature’s Way to Prevent Tooth Decay: Water Fluoridation
ADA, CDC, US Department of Health and Human Services, 2004. Argues that water fluoridation benefits everyone in the community equally, is safe and cost-effective.
Defluoridation Systems for Latin America and the Caribbean (Mexico) (5.8 MB)
PAHO & Secretaía de Salud de México 2004. Task-Force Meeting Final Meeting. PAHO’s Multi-Year Plan for Fluoridation Programs in the Region, survey of water supply, salt fluoridation and fluorosis. International Standard Regulatory Criteria for Fluoride in drinking water and technical approach for management of acceptable fluoride exposure in ground water.
Achievements in Public Health, 1900–1999: Fluoridation of Drinking Water to Prevent Dental Caries.
CDC Morbidity and Mortality Weekly Report, 1999. The ten public health achievements highlighted in this MMWR series reflect the successful response of public health to the major causes of morbidity and mortality of the 20th century.
Engineering and Administrative Recommendations for Water Fluorosis
CDC Morbidity and Mortality Weekly Report, 1995. Updated guidelines and/or recommendations for managers of fluoridated public water systems in the US.
Development of a Milk Fluoridation Scheme for Prevention of Dental Caries (484.5 kB)
WHO, 2001. Feasibility study for implementation of milk fluoridation in communities for which neither water nor salt fluoridation can be implemented.
Uso de Pastas Dentales y Consumo de Suplementos en Niños de 3-5 Años (Venezuela, Nicaragua, Honduras (1.84 MB)
OPS, 1998. Objetivos, materiales, métodos, resultados, discusión y recomendaciones con anexos: estudio de pastas y suplementos fluorurados y formulario de encuesta.
Recomendaciones Administrativas y Técnicas para la Fluoruración del Agua (3.32 MB)
OPS & US Dept. of Health and Human Services, 1997. Recomendaciones para comunidad y escuelas fluoruradas: administración, supervisión, requisitos técnicos y procedimientos de seguridad.
Fluoruración del Agua: Un Manual para Ingenieros y Técnicos (8.74 MB)
OPS, US Dept. of Health and Human Services, & CDC, 1997. El propósito de este manual es ayudar al personal de servicio de agua en el correcto funcionamiento de los sistemas de fluoruración para diseñar o planificar una instalación de fluoruración de agua de manera que los clientes puedan disfrutar de todos los beneficios de fluoruración.
Monitoring of Renal Fluoride Excretion in Community Preventative Programs on Oral Health (3.19 MB)
WHO, 1999. Study design, guidelines for tabulating and processing urine fluoride data and conclusions.
Last Updated on Monday, 04 February 2013 16:00