Noma (necrotizing ulcerative stomatitis) is a rapidly spreading gangrenous infection that commonly affects malnourished or immunocompromised individuals. It is usually a secondary complication caused by conditions like measles, tuberculosis, or HIV/AIDS. Predisposing factors include unsafe drinking water and proximity to livestock. The infection begins near the mouth and causes soft tissue necrosis and a foul odor. It can spread to involve the palate, tongue, and sometimes genitals. Treatment aims to control the infection with antibiotics and improve the patient's nutritional status. The World Health Organization and International No NOMA Federation have worked to increase awareness and reduce the global prevalence of this devastating disease.

1. NOMA
(Bacterial infections of the oral cavity)

2. CONTENTS
a.SYNONYMS
b.DEFINITION
c. EPIDEMIOLOGY
d.CAUSATIVE ORGANISMS
e.PREDISPOSING FACTORS
f. CLINICAL FEATURES
g.TREATMENT AND PROGNOSIS
h.REFERENCES

3. a. SYNONYMS – Cancrum oris , Gangrenous
stomatitis.
b. DEFINITION -
NOMA means to devour ( a
spreading sore ) is a rapidly
spreading mutilating,
gangrenous stomatitis that
occurs usually in debilitated or
nutritionally deficient persons

4. EPIDEMIOLOGY

5. AIDS related Noma prevalence is 4.3-16.0%

6. CAUSATIVE ORGANISMS

7. Other causative organisms
2
3
4

8. PREDISPOSING FACTORS-
1-NOMA is mainly secondary complication rather than primary disease .
Example : Diptheria, dysentery, Measles, pneumonia, Scarlet fever , Syphilis,
Tuberculosis, Blood dyscrasis, Anaemia etc.
2-Unsafe drinking water.
3-proximity to unkempt livestock.

9. CLINICAL FEATURES

12. Commencement of
gangrene.
Odor that from the
gangrenous tissue is
extremely foul.

13. Palate and tongue may become involved
but is not common.
Patient is with 1-increase temperature
2-suffer secondary infection.
3-may die from toxemia or pneumonia.
NOMA PUDENDI-this condition also cause
tissue damage to genitals.

14. NOMA Neonatorum

15. TREATMENT AND PROGNOSIS

17. 22 May 2008 - The FDI joined the International No NOMA Federation
and the World Health Organization in organising the first ever World
NOMA Day, which took place 22 May 2008 in Geneva
, Switzerland, to raise awareness of this neglected and little-known
devasting disease.

18. CONCLUSION
This is the strategy WHO has put in place making
the disease almost an history especially in
previously endemic area.

19. THANK YOU

20. REFERENCES
1. SHAFER’S TEXTBOOK OF ORAL PATHOLOGY DrSHAFER,Dr
Maynard HINE AND Dr Barnet Levy.
2. NEVILLE,ORAL AND MAXILLOFACIAL PATHOLOGY.
3. WWW.NONOMA.ORG
4. MANIPAL MANUAL OF SURGERY BY RAJGOPAL SHENOY
K.