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CLOSE THIS BOOKWhere There Is No Doctor - A Village Health Care Handbook (Hesperian Foundation, 1993, 516 p.)
Chapter 17 - THE TEETH, GUMS, AND MOUTH
VIEW THE DOCUMENTCare of the Teeth and Gums
VIEW THE DOCUMENTIf You Do Not Have A Toothbrush
VIEW THE DOCUMENTToothaches and Abscesses
VIEW THE DOCUMENTPyorrhea, a Disease of the Gums
VIEW THE DOCUMENTSores or Cracks at the Corners of the Mouth
VIEW THE DOCUMENTWhite Patches or Spots in the Mouth
VIEW THE DOCUMENTCold Sores and Fever Blisters

Where There Is No Doctor - A Village Health Care Handbook (Hesperian Foundation, 1993, 516 p.)

Chapter 17 - THE TEETH, GUMS, AND MOUTH

Care of the Teeth and Gums

Taking good care of teeth and gums is important because:

· Strong, healthy teeth are needed to chew and digest food well.

· Painful cavities (holes in the teeth caused by decay) and sore gums can be prevented by good tooth care.

· Decayed or rotten teeth: paused by lack of cleanliness can lead to serious infections that may affect other parts of the body.

To keep the teeth and gums healthy:

1. Avoid sweets. Eating a lot of sweets (sugar cane, candy, pastry, tea or coffee with sugar, soft or fizzy drinks like colas) rots the teeth quickly.

Do not accustom children to sweets or soft drinks if you want them to have good teeth.


“This child has a sweet tooth - but soon he'll have no more” (no more teeth).

2. Brush teeth well every day - and always brush immediately after eating anything sweet. Start brushing your children's teeth as the teeth appear. Later, teach them to brush their teeth themselves, and watch to see that they do it right.


Figure

3. In areas where there is not enough natural fluoride in water and foods, putting fluoride in the drinking water or directly on teeth helps prevent cavities. Some health programs put fluoride on children's teeth once or twice a year. Also, most foods from the sea contain a large amount of fluoride.

CAUTION: Fluoride is poisonous if more than a small amount is swallowed. Use with care and keep it out of the reach of children. Before adding fluoride to drinking water, try to get the water tested to see how much fluoride is needed.

4. Do not bottle feed older babies. Continual sucking on a bottle bathes the baby's teeth in sweet liquid and causes early decay. (It is best not to bottle feed at all.)

If You Do Not Have A Toothbrush

A TOOTHBRUSH IS NOT NECESSARY

You can use the twig of a tree, like this:


Figure

Or tie a piece of rough towel around the end of a stick, or wrap it around your finger, and use it as a toothbrush.


piece of rough towel

TOOTHPASTE IS NOT NECESSARY

Just water is enough, if you rub well. Rubbing the teeth and gums with something soft but a little rough is what cleans them. Some people rub their teeth with powdered charcoal or with salt. Or you can make a tooth powder by mixing salt and bicarbonate of soda (baking soda) in equal amounts. To make it stick, wet the brush before putting it in the powder.


Figure

IF A TOOTH ALREADY HAS A CAVITY (a hole caused by rot)


Figure

To keep it from hurting as much or forming an abscess, avoid sweet things and brush well after every meal.

If possible, see a dental worker right away. If you go soon enough, he can often clean and fill the tooth so it will last for many years.

When you have a tooth with a cavity, do riot wait until it hurts a lot. Have it filled by a dental worker right away.

Toothaches and Abscesses

To calm the pain:

· Clean the hole in the tooth wall, removing all food particles. Then rinse the mouth with warm salt water.

· Take a pain medicine like aspirin.

· If the tooth infection is severe (swelling, pus, large tender lymph nodes), use an antibiotic: tablets of penicillin or sulfonamide, or tetracycline capsules (for adults only).


Figure

A toothache results when a cavity becomes infected.

An abscess results when the infection reaches the tip of a root and forms a pocket of pus.

If the pain and swelling do not go away or keep coming back, the tooth should probably be pulled.

Treat abscesses right away - before the infection spreads to other parts of the body.

Pyorrhea, a Disease of the Gums

AN INFECTION OF THE GUMS PYORRHEA


Figure

Inflamed (red and swollen), painful gums that bleed easily are caused by:

1. Not cleaning the teeth and gums well or often enough.
2. Not eating enough nutritious foods (malnutrition).

Prevention and treatment:

· Brush teeth well after each meal, removing food that sticks between the teeth. Also, if possible, scrape off the dark yellow crust (tartar) that forms where the teeth meet the gums. It helps to clean under the gums regularly by passing a strong thin thread (or dental floss) between the teeth. At first this will cause a lot of bleeding, but soon the gums will be healthier and bleed less.

· Eat protective foods rich in vitamins, especially eggs, meat, beans, dark green vegetables, and fruits like oranges, lemons, and tomatoes (see Chapter 11). Avoid sweet, sticky, and stringy foods that get stuck between the teeth.

Note: Sometimes medicines for fits (epilepsy), such as phenytoin (Dilantin), cause swelling and unhealthy growth of the gums. If this happens, consult a health worker and consider using a different medicine.

Sores or Cracks at the Corners of the Mouth


Figure

Narrow sores at the corners of children's mouths are often a sign of malnutrition.

Children with these sores should eat foods rich in vitamins and proteins: like milk, meat, fish, nuts, eggs, fruits, and green vegetables.

White Patches or Spots in the Mouth

The tongue is coated with white 'fur'. Many illnesses cause a white or yellowish coating on the tongue and roof of the mouth. This is common when there is a fever. Although this coating is not serious, it helps to rinse the mouth with a solution of warm water with salt and bicarbonate of soda several times a day.


Figure

Tiny white spots, like salt grains, in the mouth of a child with fever may be an early sign of measles.

Thrush: small white patches on the inside of the mouth and tongue that look like milk curds stuck to raw meat. They are caused by a fungus or yeast infection called moniliasis. Thrush is common in newborn babies, in persons with the AIDS virus, and in persons using certain antibiotics, especially tetracycline or ampicillin.


Figure

Unless it is very important to keep taking the antibiotic, stop taking it. Paint the inside of the mouth with gentian violet. Chewing garlic or eating yogurt may also help. In severe cases, use nystatin.

Canker sores: small, white, painful spots inside the lip or mouth. May appear after fever or stress (worry). In 1 to 3 weeks they go away. Rinse mouth with salt water, or put on a little hydrogen peroxide or cortico-steroid ointment. Antibiotics do not help.


Figure

Cold Sores and Fever Blisters

Small painful blisters on lips (or genitals) that break and form scabs. May appear after fever or stress. Caused by a herpes virus. They heal after 1 or 2 weeks. Holding ice on the sores for several minutes, several times a day may help them to heal faster. Putting alum, camphor, or bitter plant juices (see Cardon) on them may help. No medications do much good. For information about herpes on the genitals.

For more information on caring for the teeth and gums, see Where There Is No Dentist, also available from the Hesperian Foundation.

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