Stomatitis gangrene or Noma diseaseAlso known as oris canceris a gangrenous disease that damages the hard and soft tissues of the mouth and face. In most cases, it leaves serious sequelae that make it impossible to lead a normal life.
Over the centuries it has been present all over the planet. However, at the moment has disappeared from most developed countries. It mainly affects malnourished children living in areas of the African continent where sanitation is scarce.
Although the greatest number of cases occur in those places, it occasionally affects countries on other continents as well. The extent of this pathology and its epidemiological course are difficult to determine.. The lack of statistical data makes it impossible to establish clear values in terms of incidence and prevalence.
Causes of gangrenous stomatitis
The characteristic tissue necrosis is caused by a polymicrobial infection. Some of the species that have been isolated from the affected areas are as follows:
- Fusobacterium necrophorum.
- Intermediate prevotella.
- Melaninogenic prevotella.
- Fusobacterium nucleatum.
- Bacteroides fragilis.
- Bacillus cereus.
His origin is uncertain and thought to be caused by a combination of several factors such as:
- Debilitating diseases such as systemic bacterial or viral infections.
- Hygienic deficiencies and unsanitary living conditions.
- Living in a developing country.
Without treatment it is lethal in a short time. and patients who survive have serious sequelae that make life difficult and their interpersonal relationships.
Symptoms of gangrenous stomatitis (Noma)
gangrenous stomatitis start inadvertently with inflammation and the appearance of ulcers on the gums and cheeks. The lesions spread rapidly to other structures in the mouth.
The sores produce fetid drainage that leads to bad breath and skin odor. Also, the infection spreads through the skin and tissue of the lips and cheeks. The process can end up destroying soft tissue and bone. Also, the destruction of the bone around the mouth results in tooth loss and causes deformities.
Sometimes gangrenous stomatitis can affect the genitals, spreading to the skin. Similarly, it can also affect the scalp.
In some cases, this condition can develop a number of complications, becoming fatal if left untreated. Other times, the condition can lead to severe physical deformities. The most common complications that can occur are as follows:
- facial deformity
- Difficulty speaking or chewing.
To diagnose the disease in its early stages, it is very important to take into account:
- Recent history of fever with rash.
- Oral ulcer with bone exposure.
- Excessive salivation.
- Bad breath.
- Weakness and retarded growth.
The diagnosis of an established case is not difficult due to the characteristics of the ulcers that occur.
Treatment with antibiotics and proper nutrition halts the progress of the disease. Wound cleansing and oral hygiene with antiseptics are also helpful.
In some cases, plastic surgery may be needed to remove destroyed tissue and rebuild the bones in the face, in order to improve mouth and jaw function. Complementary therapies are also necessary to rehabilitate impaired functions and to provide psychological support to the patient.
Prevention of gangrenous stomatitis
Some steps can be taken for impede gangrenous stomatitis how to improve nutrition, cleanliness and hygienic conditions. It must be taken into account that the population, and also health professionals, they have very limited knowledge of Noma.
The main measures that need to be taken to prevent the initial stages from getting worse are as follows:
- Information campaigns at national, regional and local levels to ensure that health professionals, children’s relatives and even themselves know how to take care of their health.
- Public health programs to carry out routine checkups of at-risk children. Also, implement appropriate treatments after symptoms are detected.
- Training of health professionals to teach them to recognize injuries early.
It is a fairly complex disease which, although rare, It can lead to various and even fatal complications.. Their general knowledge helps early diagnosis of cases and improved health care capacity.
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