Noma: Eradicating a Preventable Disease to Save Lives



## Scope
This policy statement provides an overview of noma, highlights risk factors, and identifies the important role that all health and social care professionals can have in identifying noma, raising awareness and caring for people affected by it, irrespective of where they live.

## Definitions
Suspected new case of noma: Any child with a mouth ulcer and other warning signs such as malnutrition, poor hygiene, recent illness from measles, persistent diarrhoea, or malaria should be considered to potentially have noma.Confirmed new case of noma: Any gangrenous disease which starts as gingival ulcerations and spreads rapidly through the tissues of the mouth and face, destroying the soft and hard tissues. 3

## Principles
This policy statement aims to raise awareness of noma across health and social care professionals internationally, to promote and improve early identification and prompt delivery of life-saving treatment, and to highlight the lifetime of special oral health care required by survivors. Ultimately, noma is preventable through tackling the underpinning social inequality. This can best be achieved by working in partnership across governmental, nongovernmental, and academic domains.

## Policy
Whilst noma does not exist in all geographic areas, FDI is inclusive and global, so this is a global call for action. FDI acknowledges that few oral health professionals work in those geographic areas of the world most affected by noma, so this issue requires a response across health and social care.
In collaboration with governmental, nongovernmental, and academic organizations FDI advocates for the inclusion of oral health for all in the policies of governments around the world.
FDI supports research to improve and share understanding of the epidemiologic and aetiologic factors contributing to the onset of noma as well as its pathophysiologic mechanisms and ways to tackle the modifiable causes of noma.All health and social care professionals FDI recommends that all health and social care professionals, particularly those working in areas where noma is prevalent, should:
Emphasise optimal oral hygiene and nutrition to help prevent the development of noma. Raise awareness amongst the local population about noma, including its symptoms and stages, its risk factors, and that it is neither contagious nor associated with witchcraft. Recognise that progression occurs within days, so early identification and prompt treatment are vital. Be familiar with the WHO treatment guidelines.Providers of education and training for health and social care professionals In areas where noma is endemic, FDI recommends that all health and social care professionals apprise themselves of education and training that: international dental journal 7 3 ( 2 0 2 3 ) 7  8 Recognises the lifelong impact of noma. Includes the basic principles of oral examination and recognition of the reversible (necrotising ulcerative gingivitis and oedema) and irreversible (gangrenous, scarring, and sequelae) stages of noma.Explains the risk factors and complex range of circumstances that lead to the progression from gingival inflammation to the gangrenous tissue destruction of noma.
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## Disclaimer
The information in this policy statement was based on the best scientific evidence available at the time. It may be interpreted to reflect prevailing cultural sensitivities and socioeconomic constraints.