01/11/2014
NOMA and Dental Balance
It is rather sad to see patients suffering from hard to repair conditions affecting the face like cancrum oris or Noma. But this could be a case to prove theories in craniofacial growth and development and perhaps build some evidence about how to cure malocclusion from a cause and effect point of view rather than symptomatic treatment.
It could be seen from the image how the dentition on the left side of this girl have shifted outwards. When NOMA affected facial tissue died off, the dentition were left out of balance, with the tongue pushing them outwards. With time, loss of such balance has resulted in the dentition migrating to a new ‘balanced’ position which is clearly not a healthy state.
It could be concluded that with sufficient time, disturbance of balance around the dentition could affect their final position. This is a good lesson to learn how loss of balance, as seen in many functional disturbances in the Head and Neck region such as breathing, mastication and swallowing, could manifest as a disturbance in the position of the dentition. From this, evidence could be built on the importance of instigating and maintaining normal functions in the Oral and Maxillofacial and Neck regions during malocclusion therapy.
Perhaps, restoring the normal facial envelope for this girl with elastic properties may at least improve the position of the dentition and make surgical reconstruction more realistic.
H.A
Bib:
Janson G; Valarelli F, Open-bite Malocclusion, Wiley Blackwell, 1st ed, 2014, West Sussex.
Ben Fogle, Facing Africa Noma, 2010, url: http://www.facingafrica.org
