Where There Is No Dentist
Author: Murray Dickson
Date: 1983-01-02T05:00:00+00:00
Keywords: Medicine; Rural; Oral Health; Dental Auxiliary Personnel; Social Science; Public Health; Dental Care; General; Study and Teaching; Dentistry; Preventive Dentistry; Developing Countries; Medical; Dental Public Health
Description: Community health workers from around the world use this book to help people care for their teeth and gums. A focus on the treatment of urgent dental problems and the importance of prevention make this book an valuable resource.
Publisher: Hesperian Foundation

INTRODUCTION
by David Werner

CHAPTER 1

Your Own Teeth
and Gums

Breast feed to help a child’s teeth Do not give a baby anything to drink grow and stay strong. An older child from a bottle. Sweet tea, sugar water can drink from a cup.

or fruit juice can easily make holes in the child’s teeth.

REMEMBER:

BREAST

IS

BEST!

YES

NO

GOOD FOR TEETH

BAD FOR TEETH

HIDING PLACES
grooves
on top
between
the teeth
near the gums

Here are 3 places where problems start.

1. Use a small branch young

2. Cut a piece that is
bamboo, strong grass or the skin still green and soft.

form sugar cane or betel nut.

3. Chew one end to make it

4. Sharpen the other end so
stringy like a brush.

it can clean between the
teeth (see pages 71-72).

Each tooth has roots

When decay

When infection
that hold it in the
touches the nerve
reaches the
jaw bone. Inside
inside the tooth
inside of a root,
each root is a nerve.

aches, even when
it is called a

(p. 39 to 40 and 45)

you try to sleep.

tooth abscess.

A tooth abscess can cause
swelling like this.

HEALTHY TEETH AND GUMS

CAVITIES AND GUM DISEASE

(1) Mix some salt with a cup of warm water. (2) Take a mouthful and rinse. (3) Spit it out. Repeat until all of the salt water is finished.

Take some into your mouth and hold it there for about 2 minutes. Then spit it out and repeat. Do this every hour you are awake.

Use hydrogen peroxide for only 3 days. Then change and start rinsing with salt water (page 7).

CHAPTER 2

Teaching Family and

Friends in Your Community

FROM THE HEALTH CLINIC…

… TO THE HOME

FROM THE SCHOOL…

… TO THE HOME

If all learners become teachers, a simple message can begin in the health clinic or school and reach many more people at home.

Sweeping the compound
in the

Brushing the teeth and gums
makes it a clean and
same
keeps them clean and healthy.

healthy place to live.

way

A small child cannot find
in the

A small child cannot see the
his own lice. Mother
same
food on his teeth. He needs
knows she must help him.

way
help with that also.

Eating different kinds of food Different vegetables
in the
helps people to grow. Eating
when planted together—
same
them several times a day makes like maize and yams—
way
your teeth and gums, as well as help each other to grow.

your whole body, grow stronger.

3.

4.

Talk with people where they gather near their homes.

Talk to men

Talk to
and women
women at
at church
health clinics
meetings,
and in the
in parents’

market. Talk
groups at their
to men at
children’s
business
school, and
and farming
at community
meetings.

meetings.

Teach men and women at reading groups.

CHAPTER

Teaching Children

3
at School

When children are interested in something, they will work hard to learn all they can about it.

This way
makes students
feel stupid.

This way lets the
students feel good,
because it makes
sense and they know
something about it.

Here a group of school children in Ajoya, Mexico is putting a high-fluoride paste (see p. 205) on the teeth of the younger
children.

These school children in Nicaragua are doing a play about cavities. On the left, germs and sweet food are combining and trying to make a hole in the ‘tooth’. But a giant toothbrush (right) beats them away!

As you find each word, put a beside it.

This is part of a flip chart presentation on There is also a
mothers’ and children’s health. Notice small copy of the
the rings at the top that hold the flip big picture on the
chart together. They are made from old back of the page
electrical cords.

before.

with 2 thin pieces of wood
with metal or wire rings

Open and close
your hand to make
it eat or speak.

To make a
bigger puppet,
attach a
cardboard face
to the bag.

1) They called their puppet show “Rotten Teeth—And A Friend’s Advice.” 2) Pedro, a schoolboy, is sad. His friends looked into his mouth and saw two teeth with big holes in them. He tells his brother he wants to walk home alone.

3) On the way, Pedro meets Maria, a friend who is a dental worker. “l’m not sad because the others are laughing,” says Pedro.“ I know the real problem.

The holes in my teeth will get bigger.

My teeth will rot and fall out, and maybe my permanent teeth coming in will rot, too.”

Maria thinks she knows what to do. “We will talk to your father,” she says.

4) One day later.

(Note how the scene behind the puppets changes. lt is a flipchart with pictures to show the different places the puppets ‘go’.)

5) “I am a poor farmer,” Pedro’s father tells Maria. “I only go to the city two times a year to sell my crops. I cannot take the boy to the city and pay for fillings in his teeth.”

Maria answers, “But we can save his teeth with a temporary cement filling.”*

6) “Then, when you have time and money, you can go to the city. I know a dental worker who will put in a permanent filling. I trust him. I will send a note with you, and it will not cost much.

”Good!” says the father. “Come on, Pedro,” says Maria, “l’II put some cement in those holes!”

7) Four months later, Pedro visits the dental worker in the city. “Maria’s good fillings saved your teeth,” he says.

“These permanent fillings will last for years.”

“Terrific!” says Pedro.

8) After the show, the puppets played a game. Throwing a ball into the audience, they asked questions like

“How do you keep cavities from happening?” Each child who caught the ball answered the question and threw it back. Then the children in the audience began asking questions for the puppets to answer. “Why did you get rotten teeth?” one child asked Pedro. The puppet looked down and said, “Too much candy!”

CHAPTER 4

School Activities for Learning About Teeth and Gums

Teacher, each day at school: Suggest ways
for your
students to eat
good healthy
kinds of food.

AND

Give your
students time
to clean their
teeth.

.

Need Teeth

No Teeth Needed
and
but not
many more!

much more!

Food that is not

Small bits of food
cleaned away
often get caught
from the grooves
inside deep lines, or
can make a cavity
grooves, in a tooth.

(hole) in them.

Look for them on

A tooth with a
the top and the sides
cavity is weak and
of back teeth.

often hurts.

Eat the food using first the front and then the back teeth.

Bite a guava using only the back teeth.

Chew completely a mango or piece of maize, using only the front teeth.

The roots of the
tooth hold it in the
bone just like the
root
roots of a tree hold it
firmly in the ground.

The roots of the tooth
root
do not actually touch
fibers
the bone. Root fibers
connect the root and
bone, holding the
tooth in place.

bone

A

B

C
top of
gum
tartar
tooth
pocket
bone
pulling
root
away
bone

A. When gum disease is beginning, a small red `pocket’ forms where the tooth meets the gum. Germs and food collect in the gum and make acid.

This makes the gums sore.

B. As a result, the gum pulls away and the pocket becomes deeper.

C. The bone moves away from the infection and no longer holds the tooth.

PERMANENT TOOTH

LOOSE BABY TOOTH

SPACE FOR NEW TOOTH

Children in Jocuixtita, Mexico, beginning a game of “Scatter!” The ‘decolonizer’ is the girl in the center with the broom.

The ‘decolonizer’ (with broom) has lost the game. The children behind him have formed a ‘colony’.

Here the decolonizer stops a boy from completing a chain.

To teach about things too small to see, look at the suggestion on page 11-29 of Helping Health Workers Learn.

Here is a larger picture of the teeth in the box above:

Vegetables, especially Peas and beans, like green Oil, from palm nut
those with dark green
beans, soybeans, winged
kernels, ground nuts,
leaves.

beans, and mung beans.

and coconut.

Fruits, like banana,

Fish, meat and eggs.

Clean water, coconut
guava, oranges,
water, and milk are best and papaya.

to drink.

each person
eat a sweet
sticky food
and…

…do

…brush
nothing
and rinse

…rinse

…eat a
only
fibrous
food

The student
can keep the

OR
brush at her
own desk…

A piece of bamboo can hold a brush nicely. Make two holes near the top for some grass string, to hang the bamboo brush holder.

… or on a
rack at the
back of the
room.

Let each student look after
her own soap and brush.

CHAPTER 5

Taking Care of

Teeth and Gums

In order to help a person it is important to know what the
problem is and what is the
best treatment. But just as
important is knowing what
you are not able to do, and
when to seek help.

In this chapter, you will learn more about teeth, gums, and
problems affecting them,
but you must never be too
proud to get help from more
experienced dental workers.

Know your limits.

Strong teeth

Weak teeth
are white and their
have yellow marks that
front surface is smooth.

are pitted and rough.

The marks are rougher than the rest of the tooth. Food sticks easily to them and turns the tooth yellow.

The marks are also soft. They need to be cleaned well every day (p. 63) to prevent them from becoming cavities. A tooth with a cavity hurts. When children’s teeth hurt, they do not want to eat as much.

You can make a large brush smaller, to fit more easily into a young child’s mouth.

Pull out some of the back hairs, or cut them out with scissors. Do not cut the hairs in half, because the tops are often rounded or softer, and that is better for the gums.

Permanent
molars

(PM) come
in behind
the baby
molars

(BM).

help

HEALTHY BABY TEETH

STRAIGHT PERMANENT TEETH
o make

10 years
adult
help

SICK BABY TEETH

CROOKED PERMANENT TEETH
to make

10 years
adult

When you see a swollen face, look for the two signs of an abscess.

See the red swollen skin on

Look behind her back teeth.

top of the new tooth.

The MAIN FOOD is at
the center of every meal.

A spoonful of cooking oil
added to a child’s food
means he only has to eat
about ¾ as much of the
local main food in order to
meet his energy needs. The
added oil helps make sure
he gets enough calories by
the time his belly is full.

Be sure always
to eat grow
foods and
glow foods
to get the
vitamins and
protein you
need.

Your energy
foods give
you the most
important

part of your
diet—calories.

Half or more
of our
calories come
from the main
food, and most
of the other
calories come
from go foods.

YES NO

You can make a hard brush softer by putting the hairs into hot water for a few minutes.

Do not put the plastic handle into the hot water, or it will melt.

OR

Rub the stem against
one tooth and then
the other. This way,
you clean the sides
of both teeth.

Get some thin cotton rope

Buy and use dental floss. This used for fishing nets. Unwind OR
is a special kind of string for and use one strand of it.

cleaning between the teeth.

Upper teeth

Lower teeth

CHAPTER 6

Examination
and Diagnosis

When you look inside someone’s mouth, ask yourself these questions.

Tell the person what is

1. A New
happening and how to

Tooth
keep the skin around it
healthy (page 66).

They may be cavities

2. Black
which should be

Spots
filled when they are
still small (page 47).

Tell the person what is

3. A Loose
happening and how to prevent

Tooth
it from getting worse or
affecting other teeth (page 54).

A tooth that is dark is dead infection from its 4. A Dark
root can go into the bone (page 47). This can Tooth
make a sore on the gums (page 74).

A bubble on the gums below the tooth is a clear sign that the person has an abscess. The abscess may be from the tooth, or it may be from the gums. To decide, look carefully at both the tooth and the gum around it.

A bubble beside a healthy tooth is a sign of infected gums. Scale the tooth carefully.

See Chapter 8.

A bubble beside a decayed tooth is a sign of a tooth abscess. (See page 93.) A sore on the gums from a badly decayed GUM BUBBLE
tooth appears when a gum bubble breaks open and lets out the pus from inside.

Use an old chair with a strong back.

Attach two flat sticks to the chair. Then tie a strip of clean cloth to the sticks. Tie it strong enough to support the head, but loose enough to let the head lean back.

Train midwives to examine
women’s mouths. When
they send women to you for
dental care, they can give
you helpful information
about the women’s health.

SWELLING

CHILD

YOUNG PERSON

ADULT

Swelling can come from:

Swelling can come from:

Swelling can come from:

mumps
a new tooth growing
a tooth abscess (p. 93)

an infection in the spit
in (p. 100)

a broken jaw (p. 113)

gland (p. 119)

a tooth abscess (p. 93)

a tumor (p. 125)

a tooth abscess (p. 93)

A SORE

CHILD

YOUNG PERSON

ADULT

A sore can come from:

A sore can come from:

A sore can come from:

impetigo
fever blisters (p. 104)

a tooth abscess (p. 93)

Vincent’s infection
a tooth abscess (p. 93)

a bone infection

(p. 102)

(osteomyelitis)

Look at the teeth:

Is a new one growing in?

Is a tooth loose?

Is there a dark (dead) tooth?

Look at the gums:

Are they red?

Is there any swelling?

Do they bleed?

Are the gums eaten away
between the teeth?

Using the end of your mirror, tap against several teeth, including the one you suspect.

There is probably
an abscess on a
tooth that hurts
when you tap it.

A TOOTHACHE

A

SWOLLEN FACE

The swelling has been there for a long time. It does not seem to get better.

A

LOOSE TOOTH

A SORE MOUTH
from

INFECTED GUMS
or

A SORE MOUTH
from a

SMALL SORE
in another
place

A SORE THAT DOES NOT HEAL PROPERLY MAY BE CANCER (See page 125).

A SORE

ON THE FACE

TROUBLE

OPENING THE

MOUTH

TROUBLE

CLOSING THE

MOUTH

CHAPTER 7

Treating Some

Common Problems

Germs hide inside bits of old food, cement, or blood on an instrument. There they can continue to live, even in boiling water.

This is why you must be sure to scrub the working end of each instrument carefully with soap and water. Rinse, and then look carefully to see that it is clean and shiny.

Be safe: When in doubt, sterilize.

DO NOT LET

THE COOKER

BOIL DRY!

The next time you use the pot, you can use the same water that was Ieft inside it.

tight fitting
lid
water
alcohol

BLEACH & WATER

½ CUP

3 + ½ CUPS

Change the solution each week.

Wrap them in a clean cloth

OR

Leave them in disinfectant

(p. 89)

Before you use any instrument Mark with tape the names
again, wash it with clean water—to of the instruments inside.

remove the taste of the disinfectant.

Keep the wax in its position
for at least 3 weeks.

flap

Infection in the gums and pressure from the new tooth are painful. notice the ‘flap’ of skin over the new tooth.

Teething does not cause fever, head colds, or cough.

But a child can have any of
these problems at the same
time as he gets a new tooth.

Feel for tartar under the gum—or even a piece of fishbone.

For a young child who is not able to rinse, Mother or Father can wipe his gums with the weak solution of hydrogen peroxide 4 times a day.

Show parents how to do this.

Give them some cotton gauze and hydrogen peroxide to take home.

Inside the mouth

On the lips

A denture which does not fit
should be remade.

In the meantime, leave the
denture out of the mouth for

2 or 3 days.

Ask the person to rinse with
warm sait water, 4 cups each
day until the sore is better.

Cracks and sores appearing at the corners of a child’s mouth are signs of dehydration and malnutrition.

1. cheek bone

2. upper jaw bone

(lower jaw joins
the head here)

3. lower jaw bone

Lie him on his side so
that his tongue and
jaw fall forward.

Place a piece of wire around 2 teeth, one on each side of the break. Choose the strongest tooth on each side—the ones with the longest or the most roots.

Tighten the wire around the two strong teeth with pliers or a hemostat.

Now join the wires. Twist and tighten them together. This may be painful.

You can inject local anesthetic—see Chapter 8. You must twist the wire tight enough to hold the broken parts together.

Tie the bandage to support the jaw, not to pull it.

Do not make it too tight. It is all right if his mouth stays partly open with the teeth slightly apart.

Be sure not to let the bandage choke the person.

NORMAL

DISLOCATED

Press down hard with the ends of your thumbs. Force the jaw to move quickly clown and back into position. Be sure to press down before you press back.

If the jaw will not move, perhaps the muscles are too tight. A doctor or dentist can put the person to sleep, which will relax the muscles.

These teeth are normal. The line formed between the two middle teeth does not shift when the mouth opens.

These teeth do not fit properly. Because the line shifts, this means the jaw is also shifting.

This shift can cause pain in the joint.

not
cleaning
properly

spit from
this gland
enters on
the inside of

TONGUE
the cheek
spit from
this gland
enters under
the tongue

Medicine cannot help.

It wastes time to use it.

CHAPTER 8

Scaling Teeth

We get tartar when the coating of germs on our teeth (p. 50) becomes hard.

Gums that press against tartar become sore and infected.

Its proper name is
lvory C -1 scaler.

Its proper name is

G-11 and 12 curette.

Sharpening stone

Mirror

Probe

Tweezers

(Arkansas stone)

(explorer)

(cotton pliers)

FOR AN UPPER TOOTH

FOR A LOWER TOOTH

Tartar starts forming deep
inside the gum pocket. If

TARTAR
you remove tartar that you
can see above the gum,

GUM POCKET
it is helpful, but not good
enough. You must remove

ROOT FIBERS
the rest of the tartar, or the BONE
infection will continue. If

part of the tartar stays on

ROOT
the tooth, the infection
will continue.

First, use the

Then, go back with your pointed-tip scaler
rounded-tip scaler and
to remove the tartar
scrape away the
that you can see.

remaining tartar.

1. Tighten your fingers 2. Pull the scaler with a on the scaler.

firm short stroke.

ALWAYS KEEP THE TIP OF

THE SCALER ON THE TOOTH—

NOT POKING THE GUM.

3. Wipe the end of the 4. Press against the gums scaler with cotton gauze.

to stop the bleeding.

Use the rounded-tip scaler in the same way as you would to remove tartar.

Feel the object, go under it gently, and then lift it out.

OR

Tie a knot in a piece of thread. Then slide the thread between 2 teeth (page 71).

However, do not move the thread up and down. Instead, pull it and the knot out the side. The knot can pull the object out with it.*

From time to time, feel the cutting edge to be sure it is sharp.

Scrape it against your fingernail. If the cutting edge is not able to cut your nail, it will not be sharp enough to break the tartar free.

Rest your 2nd or 3rd finger against the side of the stone. This is for control.

Rub the cutting edge against the stone.

Move it back and forth.

Turn the round scaler as you sharpen it.

This helps to keep the scaler’s round shape.

Remind each person: scaling is not a cure. Rather it is a way of giving her a new start. Only she can give herself the care she needs to keep her gums healthy. You have removed the hard material from her teeth, and if she brushes carefully, the tartar will not return!

135

Injecting Inside

CHAPTER 9
the Mouth

nerve (a)

enters
jawbone here
nerve (a)

nerve (b)

goes to 3
back teeth

These two injections also make the gums around the teeth numb.

swelling

The local
anesthetic must
come out against
the bone, where

YES

NO
the nerve is.

blood

1

CHAPTER

0

Cement Fillings

OR
probe
tweezers
spoon
filling tool
mixing tool
mirror

(explorer)

(cotton pliers)

(spoon excavator)

(filling instrument)

(cement spatula)

Oil of cloves is a liquid.

Zinc oxide is a powder.

your syringe, needle,
oil of cloves
and local anesthetic

(eugenol) and

(in case a tooth hurts)

zinc oxide

Your instruments:

lots of cotton:

mirror, probe,
cotton rolls,
tweezers, spoon,
gauze, or
filling tool,
cotton wool
mixing tool
smooth glass to
mix cement

Suggestion: Practice with the cement ahead of time.

You can then find out the time it takes to become hard.

before
after

If you have no carbon
paper, darken some
paper with a pencil.

In India and Guatemala, health workers use a foot treadle to power a drill, the same way they operate a sewing machine. This kind of drill is Village dental workers in the slower than a compressed-air drill, mountains of western Mexico use and the grinding produces a lot of bicycle power to make compressed air, heat, so one must take care not to which runs a high speed drill.

let the tooth ge so hot that it kills Local young people or family members the nerves (see p. 152). Still, this is volunteer to pump the air while they one of the simplest and cheapest wait to have their own teeth fixed.

ways to place a permanent filling.

CHAPTER 11

Taking Out a Tooth

A spoon or probe…

… an elevator…

… and two forceps

150
upper universal forcep

151
lower universal forcep

Use this to

An elevator will

Use forceps to pull out the separate the gum
loosen a tooth, or lift
tooth. There is one for upper from the tooth.

out a broken root.

teeth and one for lower teeth 87

‘cowhorn’

forcep

73
lower molar

‘hawk’s bill’

forcep

18R

18L
right
left
upper
upper
molar
molar
forcep
forcep

30

31

Cryers elevators

To take out a lower tooth, you need To take out an upper tooth, you need to push down and then pull up.

to push up and then pull down.

So the person should be

So the person should be
sitting down low.

sitting up high.

If you stand on a box, he will be lower.

If he sits on cushions, he will be higher.

a syringe,
needle, and
local anesthetic
forceps
an elevator
cotton gauze
spoon instrument

Use this
or this

Front Side

Back Side

Put pressure on the bone, not the tooth beside it. Do not loosen the good tooth!

If a tooth has 1 root, you can turn it.

If a tooth has 2 or 3 roots, you need to tip it back and forth.

Removing a tooth is like pulling a post out of the ground. When you move it back and forth a little more each time, it soon becomes loose enough to come out.

If the looser gum is on the outside, you will bring the needle toward the tongue. Protect the tongue with a tongue blade or your dental mirror.

You must suture both the upper and the lower gums in this way.

After this you must tie 2 knots and cut the thread. See the next page.

Wrap the longer end of thread 2 times around the beaks of the needle holder.

Then grab the shorter free end of the thread with the tip of the needle holder. With the needle in your fingers, pull the needle holder in the opposite direction. The thread will slide off the beaks and form the first knot.

Wrap the thread once around the beaks of the needle holder.

Grab the free end with the tip of the needle holder as you did before. Pull the two ends in opposite directions. The second knot will form over the first knot.

Always give the person some extra cotton gauze to carry home, in case bleeding starts again later.

Show her how to use the cotton gauze.

A person
without many
teeth looks old.

With a new set of
plastic ‘false teeth’,
the same person
looks and feels
much younger.

1. Force the blade between 2. Move the root away the root and the socket.

from the socket wall.

3. Move the root further 4. Grab the loose root and until it is loose.

pull it out.

1. Break away the bone between 2. Force the blade between the root and the blade.

the root and the socket.

3. Move the root away 4. Grab the loose root and from the socket wall.

pull it out.

Gently reach into the socket with the end of an elevator or spoon instrument. Feel for the piece of bone and carefully lift it out.

Give local anesthetic if needed.

Use a brush and clean each

Then kill the germs by
instrument with soap and water.

placing the instruments into
a covered pot of boiling

Be careful to scrub away all bits water for 30 minutes.

of old dried blood.

12

HIV and Care

CHAPTER
of the Teeth and Gums

For people with HIV, good dental care can mean the
difference between living and dying.

If a person with HIV has a clean and healthy mouth,
he or she will be able to eat well, be stronger, feel better, and live longer.

I can treat the

He may have passed
problem in David’s
the infection to you,
mouth, but I think he
so it would be good
has a serious infection.

for you to be tested.

The right information will help dental workers give good dental care to everyone.

HIV is not spread by casual contact.

Most mouth infections
are not caused by

HIV, but all mouth
infections are serious
when a person is
infected with HIV.

Wear glasses or goggles. Make sure you can see through them clearly.

Wear a clean cloth or mask over your nose and mouth. Try to
change the cloth several times a day. Before wearing a cloth again, wash it in clean soapy water, rinse, and hang it in the sun to dry.

Wear clean gloves or plastic
bags on your hands.

Before you examine
someone, always
explain carefully
what you are going
to do.

Feel along the jaw, underneath the jaw bone, and on the upper neck to see if there are any lumps or pain.

No one else should know if someone has HIV, except
for those the person wants to know. If you think it is important to tell others, always ask for permission first.

If you know or think
someone is infected with

HIV, do not tell anyone
else—even the person’s
family.

Anyone with HIV/AIDS
has the right to get good dental care and to be
treated with respect.

Mix hydrogen peroxide

Hold some

Spit it out and
evenly with water—that is
in the mouth
repeat. Do this

½ cup of hydrogen peroxide
for about
every hour when
with ½ cup of water.

2 minutes.

awake for 3 days.

White, yellow,
or (sometimes)

red patches. The
patches in this
picture are behind
the bottom, front
teeth, but they
most often appear
on the roof of the
mouth and the top
of the tongue.

tea tree

Open sores (ulcers) that
can appear anywhere in
the mouth. Usually the skin
around the sores is red. The
sores in this picture are on
the inside of the top lip.

The skin around the teeth

(the gums) is painful, red
and puffy with oozing
yellow liquid (pus).

Painful red blisters on
the gums that have burst
open and become small,
open sores.

Painless, red-, brown-,
or purple-colored
patches (that look like
swollen bruises). They
can appear anywhere in
the mouth. The patches
in this picture are on the
top (roof) of the mouth.

How risky are different kinds of sex?

sex in the anus without a condom sex in the vagina without a condom sex with many people
sex when the vagina is dry
sex with someone who has had sex with many people
sex without ejaculation

(“pulling out”)

sex using a diaphragm
sex with only one person who
only has sex with you
oral sex

(mouth on penis or vagina)

sex using a condom
kissing or touching
mutual masturbation

HIV is not a curse or a
punishment.

A person with HIV can get sick very easily with many common health problems such as pain, cough, skin rashes, fever and diarrhea. For information about these problems, see Where There Is No Doctor, or another general medical book.

Help people with the
resources you have,
and think about where
you might find more
resources to help meet
people’s needs.

Fight to end discrimination against those infected with HIV. Discrimination is an obstacle to care. It may stop people from coming for treatment and it may stop people from learning how to prevent the spread of infection.

Get Rid of Wastes Safely

The Dental Kit

Babies take

Adults

Childen 8–12

Children 3–7
acetaminophen
take 2 tablets
take 1 tablet
take ½ tablet
only, ¼ tablet

.5

1

1.5 2 2.5

3

3 ml syringe

You will usually use

For very severe infections, give

‘aqueous procaine

‘crystalline penicillin’ every penicillin’. Give only

6 hours for the first day. It acts 1 injection per day.

quickly and for a short time only.

… with wire:

… with glue or even wax:

bottom of
working
piece
goes
in this
slot

(1) Soak thin string in hot wax.

(2) To remove the extra wax, pull the string between your fingers.

Records, Reports, and Surveys Here are the short names of 4 teeth.

Can you find the tooth named LL5?

Resources

VOCABULARY

A

B

Abscess A sac of pus caused by an infection.

Baby teeth

The first set of teeth. There are For example, a boil.

20 baby teeth, which are also called milk Acid

A strong liquid that is produced from teeth or primary teeth.

certain foods left in the mouth. Acid causes Bacteria

Tiny germs that you can only
both tooth decay and gum disease.

see with a microscope and that cause many Acute Sudden and short-lived. An acute illness different infectious diseases.

is one that starts suddenly and lasts a short Beeswax

Wax made by honey bees.

lime. The opposite of ‘chronic’.

Bicuspids

The teeth between the canine

Adrenaline Also
called
epinephrine. A drug
teeth and the molars; premolars.

which stimulates the heart, used for severe Bite (1) To cut with the teeth. (2) The way the allergic shock.

upper and lower teeth fit together when Adult teeth See

Permanent teeth.

they close.

Allergy

A bad reaction after breathing in, Blood pressure

The force, or pressure, of the eating, touching, or being injected with blood flowing through the blood vessels something. The reaction may be itching, (veins and arteries).

sneezing, or difficult breathing.

Blood vessels

Tubes that carry blood through Analgesic Medicine to calm pain. Aspirin, the body. Veins and arteries.

acetaminophen (paracetamol), and codeine Boil (1) To heat water until it bubbles. (2) A all are analgesics.

swollen, inflamed lump with a pocket of Amalgam A special metal used in permanent pus under the skin. A kind of abscess.

fillings.

Brand name

Trade name, the name

Anemia

A disease in which the blood gets a company gives to its product. A thin. Signs include tiredness, pale skin, and brand-name medicine is sold under a lack of energy.

special name and is often more expensive Anesthetic

A drug that causes the mouth or than the same generic medicine.

other part of the body to feel numb.

Bridge

False teeth that are glued onto Antibiotic

Medicine that fights infections several nearby healthy teeth.

caused by bacteria. A broad-spectrum Buccal

Of the cheek. The buccal face of a antibiotic such as tetracycline kills many tooth is the side facing the check.

kinds of bacteria, while a narrow-spectrum Bulk

Large quantity or amount.

antibiotic like penicillin kills only a few kinds of bacteria.

Appropriate

Something that is the easiest, C
safest, and most likely to work in a particular situation or condition.

Calcium

A nutritional element which makes Arkansas stone A special stone used to teeth strong and hard.

sharpen dental instruments.

Calculus Tartar.

Aspirate To breathe. An ‘aspirating syringe’ is Calories

Units of heat found in food, giving one that can ‘breathe’, or allow liquid to go energy for the body to use.

both in and out of the needle tip.

Cancer A tumor or lump that grows and may Drill

An instrument used to change the keep growing until it causes death.

shape of a cavity before placing a filling.

Canine teeth

Also called cuspids, dog teeth, Duct

A tube that carries liquid. For and eye teeth. These teeth have the longest example, ducts carry spit from the spit roots of any tooth.

gland to the mouth.

Carbohydrates Starches and sugars—foods E
that give energy. In this book they are called GO foods.

Elevator An instrument used to loosen a tooth Caries Cavities; tooth decay.

before you take it out.

Cavity A hole in a tooth where bacteria have Enamel The protective layer that covers the entered.

crown (top part) of a tooth. The enamel is Cement filling A temporary filling, which the hardest part of the body.

may protect a tooth for up to 6 months. Also Epulis A tumor of the gums, usually found see Filling.

between the teeth.

Cementum The outer covering of the tooth’s Eruption The moment when a new tooth cuts root.

through the gums and becomes visible in Chronic Long-term or frequently recurring the mouth.

(compare with ‘acute’). A chronic disease is Evaluation A study to find out the value of one that lasts for a long time.

something, or to find out what has been Colony

Germs grouped together in one accomplished. Evaluations often compare place.

different conditions before and after a new Contagious disease A sickness that can be activity begins.

spread easily from one person to another.

Examination A careful look at something; an investigation.

Contraindication A situation or condition when a particular medicine should not Expiration date The month and year be taken, or a certain treatment not marked on a medicine that tells when it given. For example, many medicines are will no longer be good. Throw away most contraindicated during pregnancy.

medicines after this date.

Crown The top 1/3 of the tooth, the part that Explorer See

Probe.

is protected with hard enamel.

Extraction

Taking out a tooth.

Curette A scaling instrument.

F

Cuspids Canine
teeth.

Cyst

An abnormal, sac-like growth in the False tooth A ‘tooth’ made of plastic or other body which is often filled with water.

material, used to replace a tooth that has been taken out.

Fever A body temperature higher than D
normal.

Decay See Tooth Decay.

Fiber A fine, threadlike piece. A fibrous food like coconut contains a lot of fiber.

Dentition

A whole set of teeth.

Filling Material put into the cavity in a tooth Dental floss See

Floss.

to prevent further decay.

Dental worker

A health worker who works
for healthy teeth and gums.

First aid Emergency care or treatment for someone who is sick or injured.

Dentist

A professional who has advanced formal education in care of teeth and gums.

Floss Special string used to clean between the teeth.

Dentures False
teeth.

Fluoride A chemical which strengthens the Diagnosis A decision made by a health teeth. Painted on the teeth, as an ingredient worker about what a person’s illness is.

in toothpaste, or added to water for drinking Diet

The kinds and amounts of foods that a or rinsing, fluoride enters and hardens the person should eat or avoid eating.

enamel. It is especially good for children’s Dislocation

A bone that has slipped out of teeth.

place at a joint.

Forceps

Instruments used to pull teeth Distal

The side of the tooth that faces the Fracture A broken bone.

back of the mouth. The opposite side from the ‘mesial’ side.

G

Infection A sickness caused by bacteria or other germs. Infections may affect part of Gauze A material made of cotton, woven into the body only (such as a sinus infection) or an open mesh.

all of it (such as measles).

Generic name The scientific name of a Infectious disease A disease that is easily medicine. Usually different from the brand passed from one person to another; names given it by the different companies contagious disease.

that make it.

Inflammation An area that is red, hot, and Germs Very small organisms that can grow painful, often because it is infected.

in the body and cause some infectious Inject To give a medicine such as an diseases; bacteria.

immunization or anesthetic, using a syringe Gram A metric unit of weight. There are about 28 grams in an ounce. A paper clip weighs about 1 gram.

J

Groove A long, narrow cut on the surface of Joint The place where two bones meet.

back teeth. Grooves are ‘protected areas’

When this book talks about the ‘pain in because food and germs can hide and the joint’, it means the joint (called the remain in them longer.

‘temporomandibular joint’) where the cheek Gum bubble Also called a gum boil. A small and jaw bones meet.

abscess on the gums.

Gum disease Illness that causes gums to K
become loose, red, and swollen, and to bleed when the teeth are cleaned.

Kilogram (kg) One thousand grams. A ‘kilo’

Gum pocket The space between the tooth weighs a little more than 2 pounds.

and the flap of gums around it, forming a small pocket.

L

Gums The skin around the teeth.

Labial Of the lips. The labial side of a tooth is H
the face of the tooth nearest the lips.

Ligature wire A thin, strong wire that bends Hemorrhage Bleeding.

easily, used to attach a loose tooth to a Hemostat A needle holder, used for putting in strong tooth.

sutures.

Lingual Of the tongue. The lingual side of a Herb A plant, especially one valued for its tooth is the face of the tooth nearest the medicinal or healing qualities.

tongue.

History (Medical history) What you can learn through asking questions about a person’s M
sickness—how it began, when it gets better or worse, what seems to help, whether Malnutrition Health problems caused by not others in the village or family have it, etc.

eating enough of the foods that the body Hydrogen peroxide A liquid used to clean needs.

wounds and kill certain bacteria.

Mandible The lower jaw bone.

Hypertension

High blood pressure.

Maxilla The upper jaw bone.

Mesial The side of the tooth that faces the front of the mouth; the opposite of ‘distal’.

I

Milligram (mg) One thousandth of a gram.

Immunizations (vaccinations) Medicines that Molar The back teeth, used for grinding.

give protection against specific diseases. For Molars are the largest teeth in the mouth, example, there are immunizations against with 2 or even 3 roots each.

diptheria, tetanus, polio, tuberculosis, and measles.

Incisors The four front teeth on the top and bottom.

N

Pus A yellow-white liquid found inside infections.

Nerves Thin threads or strings that run from R
the brain to every part of the body and carry messages for feeling, pain or movement.

Records, reports

Written information about

There is a nerve, along with a blood vessel, sick persons and the treatment they receive.

in every root of every tooth.

Records are for the personal use of the Numb Without feeling; anesthetized. When health worker, reports are written by one teeth and the gums around them are numb, health worker to another to describe an they cannot feel pain.

illness and ask for further treatment.

Nutrition

The mixture of foods the body Resistance The ability of something to defend needs to grow, be healthy, and fight off itself against something that would normally disease.

harm or kill it. Many bacteria become resistant to the effects of certain antibiotics.

O

Rinse

To hold a liquid in the mouth, moving around inside the mouth.

Occlusal The biting surface, or top, of the Risk

The possibility of injury, loss, or harm.

tooth.

Danger.

Oral Of the mouth. An oral medicine is one Root

The lower part of the tooth, under the taken by mouth.

gum, connected to the bone.

Organisms Living things (animals or plants).

Root canal

The hollow part of every root of a tooth, which has a blood vessel and a nerve P
inside,

Root canal treatment

A special operation

Palate The roof or top part of the mouth.

on a dead tooth to remove material from Permanent filling A filling using a special the root canal and replace it with filling metal or ceramic material which lasts for material.

years.

Root fibers

Tiny fibers which hold the root of Permanent teeth

The 32 adult teeth which
the tooth to the jaw bone.

grow into the mouth to replace the baby teeth.

S

Petroleum jelly (petrolatum, Vaseline) A grease-like jelly used in preparing skin Saliva

Spit. Saliva helps us to swallow our ointments.

food.

Plaque A film or coating of germs that can Scab The crust of dry blood that forms over a form on the teeth, mix with food and make wound.

acid. You cannot see plaque unless you stain Scale To scrape the tartar off the teeth. A scaler it.

is an instrument for scaling.

Plate A set of false teeth.

Scientific method

A way of learning

Premolars

The teeth between the molars and something. It begins with information, then the canine teeth; bicuspids.

an idea, and then the idea is tested against Prenatal Before
birth.

the information available.

Prevention

Action taken to stop sickness Side effects Problems caused by using a before it starts.

medicine.

Probe

An instrument for examining teeth for Signs The things or conditions to look for tartar or other problems.

when you examine a sick person, to find out what sickness the person has. In this book Protective foods

Foods that are rich in
the symptoms (the problems a person feels) vitamine and minerals. They help build are included with signs.

healthy bodies and make people more able to resist or fight diseases. ln this book they Sinus

A hollow place inside the bone.

are called GLOW foods.

Socket

The wound left after you take out a Proteins

Body-building foods necessary for tooth.

proper growth and strength. In this book Soft drinks

Fizzy, carbonated drinks like they are called GROW foods.

Coca-Cola.

Spatula

An instrument used for mixing cement Top of the tooth

The part of the tooth that
for fillings.

bites on food. For both upper and lower Starches

Energy foods like maize, rice, wheat, teeth, the biting surface is the ‘top’ and the cassava, potatoes, and squash.

root is at the ‘bottom’.

Sterile Completely clean and free from living Topical

On top of the skin. A topical micro-organisms. Things usually are not medicine is put on the skin.

sterile until you boil them or steam them.

Traditions

Practices, beliefs, or customs Sterilize To make things sterile by boiling or handed down from one generation to steaming for 30 minutes.

another by example or word of mouth.

Sugars Sweet foods like honey, sugar, or fruit Treatment Care given by a health worker that give energy but often cause tooth and to fight an illness, attend to an injury, or gum problems.

prevent a new problem.

Survey

A collection of facts about a small Tropical Having to do with the tropics—the group of persons or things in the community.

hot regions of the world.

If the small group is not unusual, the survey Tumor

An abnormal mass of tissue without results will describe the whole community.

inflammation. Some tumors are due to Suture

A stitch made with needle and thread cancer.

to sew up an opening or wound.

Tweezer Small metal instrument for picking up cotton or small objects. Some persons Swelling

An area of the skin that is abnormally use the word forceps for tweezers, but in large, puffed up. A swollen area is one that this book, forceps are instruments for taking has swelling.

out a tooth.

Symptoms

The feelings or conditions that sick persons report about their sickness.

U
ln this book, symptoms are included with signs.

Ulcer A break in the skin or mucus Syringe An instrument with a small sharp membrane; a chronic open sore that can needle, for giving injections.

appear on the skin, gums, or gut.

T

V

Tablespoon

A measuring spoon that holds 3

Vaccinations See

Immunizations.

teaspoons or 15 ml.

Vaseline See

Petroleum jelly.

Tartar

A hard, rocky coating on the tooth near Vessels See

Blood vessels.

the gums, also called calculus or toothstone.

Tartar forms when old plaque mixes with Virus Germs smaller than bacteria, which calcium in the spit.

cause some infectious diseases, like measles Teaspoon

A measuring spoon that holds 5 ml.

or the common cold.

Three teaspoons equal one tablespoon.

Vitamins Protective foods that our bodies need Teething

The action of new teeth cutting to work properly.

through the gums. Also see Eruption.

Volume The amount of space a thing occupies.

Temperature The degree of heat of something, We measure volume in liters, ml, gallons, etc.

such as the air or a person’s body.

Temporary filling

A filling meant only to last

W
until a permanent filling can be placed.

Weight The heaviness or lightness of a thing.

T.M.J.

The temporomandibular joint. See We measure weight in kilograms, mg, Joint.

pounds, etc.

Tooth abscess See

Abscess.

Wisdom teeth

The 3rd molars, which grow

Tooth decay

Damage to the tooth caused by into the mouth when a person is 16-22 years acid; cavities.

old.

Toothache

Pain in a tooth.

X

Toothpaste

A paste for cleaning teeth.

Tongue depressor

A tongue blade; a piece

X-ray A special photograph that allows you to of wood used to keep the tongue out of the see bone, roots of teeth, etc., under the skin.

way when examining or treating the teeth.

A

Bacteria (See Germs)

Bandage, head, for a broken jaw, 110

Abscess, 93, 217

Berry juice

and gum bubble, 74

used to show coating of germs on teeth, 53

begins with a cavity, 6, 47

Bicycle-powered dental drill, 151

diagnosis and treatment, 93

Bleeding

flip chart presentation, 30-31

and extractions, 77, 153-154

treat at once before infection reaches the from socket: diagnosis and treatment, 118
bone, 6

how to place a suture, 161-162

treat pregnant women, now, 15-16

in the mouth: possible causes (chart), 116

Acetaminophen (paracetamol) Bleach, for disinfecting without heat, 89

dental kit supply, 202

Blood

dose for pain, 94-95

boil any instrument that has touched blood, Acid

87

causes tooth decay and gum disease, 7, 50, (Also see Bleeding)

217

Blood pressure, 77, 118

some sugars make acid more easily, 55

Blood vessel, 46

Adrenaline (epinephrine), 136, 137, 203

Bone

AIDS, Chapter 12, 169

bone chips inside tooth socket, 166

(See

HIV/AIDS)

broken: diagnosis and treatment, 108-112

Alcohol, for disinfecting without heat, 89

damage from gum disease, 42

Allergies to medicines

three main bones in the face, 108

and extractions, 153-154

Bones of animals, 41

penicillin warning, 203

Books on dental care, 215-216

Anemia, 16, 123, 217

Bottle feeding, 3, 63

Anesthetics, local, 135-142

Breast feeding, good for teeth, 3

dental kit supply, 205

Broken bone, 108-112

Antibiotics, 94, 217

Broken root, 165

dental kit supply, 202, 204

Broken tooth, 96

doses for tooth abscesses and other Brushing teeth (See Cleaning teeth) problems, 94

Brushstick (homemade toothbrush), 4
injections,

203-204

Bubble (See Gum bubble) precautions,

203
sulfadimidine,

123

warning on tetracycline, 63

C

Anti-retrovirals (ARVs), 171

Cancer, 125, 218

Arkansas stone, 128

can begin with white lines inside mouth, Aspirating syringe, 136, 207, 217

105

Aspirin, 94
diagnosis,

125

correct dose for pain, 94-95, 203

Kaposi’s Sarcoma, 188

dental kit supply, 202

look for a sore that does not heal, 106

do not hold against teeth, 203

Candy, 9

(Also see Sweet foods)

B

Cancrum oris (noma)

Baby teeth, 62-65

diagnosis and treatment, 121-124, 185

ages when baby teeth come in, 43, 64

Canker sores, diagnosis and treatment, 106

Begin forming before birth, 62

Cartridges of injectable anesthetic, 135-136, do not cause diarrhea and fever, 65

205

how baby teeth grow and stay strong, 63

Cavities (caries), 218

knocked out: diagnosis and treatment, 97

can begin as marks on baby teeth, 62
loose,

54

can become abscesses, 47

make space in mouth for permanent teeth, 64

can make teeth hurt, 46

marks on baby teeth, 62

caused sometimes by baby bottles, 3

why baby teeth are important, 64

diagnosis and treatment, 92
g

Cavities (continued)

D

fill cavities before abscess forms, 6

flip chart presentation, 30-31

Demonstration, 26, 48

on neck of tooth, 92, 205

Dental floss, 71-72, 210

puppet show about, 33-34

Dental kit, supplies for, 201-211

school survey, 49

Dental mirror, 75, 209

Cement fillings (See Fillings) Dental tools (See Instruments) Chair for examinations and extractions, 75, 156

Dental workers, can visit schools, 35

Cheek bone, 108

Dentures, 163-164

CHILD-to-child program, 24

bad dentures cause sore mouth, 107

Children

sores under, diagnosis and treatment, 106

as health workers, 24

Diabetes, and extractions, 153-154

can clean their own teeth, 58

Diagnosis (See Examination and diagnosis) cannot learn well if their teeth hurt, 20

Diagnosis charts, 80-83

want to learn, 19

loose tooth, 81

young children should not take aspirin, 94, sore mouth, 82

203
sores

82-83

Cleaning instruments, 75, 87-91
swelling,

81

after extractions, 167
toothache,

80

after filling a tooth, 150

trouble opening or closing mouth, 83

after scaling, 134

(Also see Comparative diagnosis) disinfecting without heat, 89

Diet (See Nutrition)

how to sterilize syringes, 138

Dilantin (diphenylhydantoin) 115

pressure cooker, 88

Dislocated jaw

sterilizing with steam, 87-88

after extraction, 167

wash your hands, too, 86

diagnosis and treatment, 113

Cleaning teeth, 56, 69-72

Disinfectant, cold

can help sore gums, 7

for cleaning certain instruments, 89, 206

CHILD-to-child activities, 24, 53

Drama, for teaching about tooth problems, 26

especially important for persons who take Drawing pictures, 31
certain medicines, 115

Drill, dental, 151-152

experiment to find the best way, 58

Dry socket, diagnosis and treatment, 117

flip chart presentation, 31

how to clean a baby’s teeth, 63

how to clean between teeth, 71-72

E

how to make a brushstick, 4

how to make a child’s toothbrush, 63

Elevators for extractions, 155-156, 207

how to make waxed floss, 210

how to use, 158

make it part of a daily school activity, 59

Epilepsy

parents should clean children’s teeth, 11, 18, and swollen gums: diagnosis and treatment, 63

115

pregnant women must take special care,16

Epinephrine (adrenaline), 136, 203

‘protected areas’ that are hard to clean, 4

Epulis, 133

soft toothbrush is best, 4, 70

Erythromycin, 94

(Also see Gum disease, Scaling teeth) dental kit supply, 202

Coating of germs on the teeth, 50

Eugenol (oil of cloves), 145, 205

Cola drink, in experiment on decay, 48

Examination and diagnosis, Chapter 6, 218

Cold sores (fever blisters) bleeding in the mouth (chart), 116

diagnosis and treatment, 104, 186-187

different problems come at different ages,

‘Colonies’ of germs on the teeth, 50, 218

78

Comparative diagnosis (telling similar problems examining inside the mouth, 79
apart), 80-83

four steps to a good diagnosis, 76

Cotton rolls, 146, 205

and HIV, 174-176

‘Cowhorn’ forceps, 155

how to check the gums, 74

do not use on baby teeth, 160

look for sores, 74

Curette (for scaling teeth), 128

questions that help you make a diagnosis, 73, 76

73, 76

Examination and diagnosis (continued) G

telling similar problems apart, 80-83

Game (‘Scatter!’), 50-51
tetanus,

118

Generic name, 202

touch the sore place, 79

Germs, 219

wear protective equipment, 174

discussion about, 51

where to examine, 75

health workers must not spread germs, 85-

(Also see Diagnosis charts)

87

Excavator, 145

impossible to kill all germs in mouth, 50

Expiration date, 218

where they hide, 87

Extractions, Chapter 11

Gingivae, gingivitis (See Gums, Gum disease) before you begin—ask questions! 153

Gloves, 86, 174, 200

four problems to watch for, 154

‘Go foods’ (energy foods), 67-68

how to take out a tooth, 157-163

warning about, 68

instructions: what to do afterward, 163-167

Grooves on teeth, 92, 205, 219

instruments needed, 154-156

Gum boil (See Gum bubble) for people with HIV, 177

Gum bubble, 47, 74

pregnant women need not wait, 15-16, 77

Gum disease, 52-53

problems afterward, 116-117, 165-167

description, 42, 52

three reasons to take out a tooth, 153

diagnosis and treatment, 101-103

flip chart presentation, 30-31

F

home care for, 53

False teeth, 163-164

how gum disease makes teeth fall out, 42

(Also see Dentures)

learning activity about, 53

Fever blisters,

noma: diagnosis and treatment, 121-124

diagnosis and treatment, 104, 186-187

picture of, 7

Filing teeth to correct a bad bite, 99

possible cause of a sore mouth, 82

Filling tool, 145

prevent gum disease during pregnancy, 16

Fillings, Chapter 10

serious gum disease: diagnosis and filling material, 145, 205

treatment, 8, 102-103, 121-124

how to place, 146-150

Gum pocket, 52, 131, 219

instructions for after you place a filling, 150

Gums

instruments needed, 145
definition,

219

lost or broken: diagnosis and treatment, 92

importance of, 1, 37

permanent fillings, 151-152

infected gums (noma): diagnosis and puppet show about, 33-34
treatment, 121-124

two kinds, 144

healthy and unhealthy gums: description, 52

what a filling can do, 144

how to examine, 74

when not to place a filling, 143

swollen gums and epilepsy medicine, 115

when to place a filling, 144

swollen gums and pregnancy, 16, 77, 102

Fish bone

why gums can feel sore, 7, 52

can get caught under gums, 133

Flannel-boards, 28, 218

H

Flesh, left inside socket after extraction, 166

Flip charts, 29-31, 218

Hands
example,

30-31

wash before you touch someone’s mouth, Flossing (cleaning between teeth), 71-72, 210, 86

218

Head bandage for a broken jaw, 110

Fluoride, 24, 70, 218

Heart disease, and extractions, 153-154

on neck of tooth, 92, 205

Heat, can lower swelling, 94

rinse and paste to prevent cavities, 205

Hemorrhage, and extractions, 153-154

Food (See Nutrition)

Hemostat, 161

Forceps for extractions, 155, 207

Herpes virus, can cause fever blisters, 104, Fracture (See Broken bone, tooth, root) 186-187

HIV, Chapter 12, 169

Jaw bone, 41
common problems, 178

broken: diagnosis and treatment, 108-112
definition, 171

dislocated: after an extraction, 167
dental care, 177

dislocated: diagnosis and treatment, 113
and food, 189

three main bones in face, 108
how it spreads, 172

Joint, 219
general treatments, 178-179

pain in: diagnosis and treatment, 114
prevention, 191-195

Hydrogen peroxide, 8, 179

K
warning: do not use too much, 8

Hygiene (keeping clean), 82-85, 86-90, 178-Kaposi’s Sarcoma, 188

179

L

I

Learning (See Teaching) Incisors, 39

Lidocaine (lignocaine), 136

Infection, 219

dental kit supply, 205

can pass from tooth to bone, 47

Ligature wire, 110, 219

dental workers can infect others, 85

Loose teeth, 54

description of infected gums, 52

diagnosis and treatment, 99

during pregnancy, 15-16, 77, 96, 148

possible causes (charts), 81, 99

in sinus: diagnosis and treatment, 95

in spit gland: diagnosis and treatment, 119

M

Injections, Chapter 9, 204, 219

how to give injections to children, 141

Main food, 67-68

injections of antibiotics, 204

Malaria, can contribute to noma, 121

instructions for after you give an injection, Malnutrition, 219

142

cavities can help cause, 62

safe disposal, 199

often made worse by Vincent’s Infection, sterilization of syringes, 138

102

two types of syringe, 135-136

(Also see Nutrition)

use an aspirating syringe, 138

Mango string, can get caught under gums, 133

Instructions

Measles

what to do after extracting, 163-167

can cause dry, sore lips, 107

what to do after injecting, 142

can contribute to noma, 121

what to do after placing a temporary Medicines in dental kit, 201-204
filling, 150

Mepivacaine, 137

what to do after scaling, 133

Milk-oil drink

Instruments, 207-211, 219

for persons who cannot eat properly, 111

boil any instrument that has touched blood, Mirror, 75, 209

87

Molars, 39, 43, 219

buying instruments, 211

ages when molars grow in, 43

for examination, 75

baby molars, 64

for extractions, 155-158

first permanent molar is often the first for filling teeth, 145
permanent tooth, 64

for scaling, 128

infection in new molar: diagnosis and making your own instruments, 208-210
treatment, 100

(Also see Cleaning instruments) new molar can cause face to swell, 66

I.R.M. (Intermediate Restorative Material), 145
often grow in badly, 43

taking care of, 66

J

Mouth

dry or painful, 189

Jamaica

trouble opening and closing (chart), 83

dental workers’ description of gum disease, white lines inside the mouth can be cancer, 42

105

Index N-O-P-R-S

N

Pictures

as a teaching aid, 28, 37-38

Neck of a tooth, grooves in, 92
tracing,

31

Needle, hypodermic

Plaque, 50, 220

disposable, for oral anesthetic, 205

disclosing solution (berry juice), 53

safe disposal, 199-200

Plays, 26

used to wire a broken jaw, 112

Posters, 28

Nerve of a tooth, 46, 220

Pregnancy, 15-16

main trunks and small branches, 136-137

and dental problems, 15-16, 77, 102, 154

Noma (cancrum oris)

women must take special care, 101

diagnosis and treatment, 121-124, 185

story about, 15-16
prevention, 124

Pressure cooker for sterilizing instruments, 88

Nutrition, 67-68, 220

Prevention, 35, Chapter 5, 220

eat a mixture of foods, 11, 67-68

early treatment is a form of prevention, 61

eat enough food, 67

foods that are good and bad, 55

flip chart presentation, 30-31

HIV,

191-195

foods for persons who cannot eat properly, (Also see Cleaning teeth, Nutrition) 111, 189

Probe, 75, 209

foods that make gums stronger, 7, 8

Pronunciation, why teeth are important for, 37

foods that we cannot eat without teeth, 38

Puppet shows, 32-34
good and bad foods, 55
example,

33-34

good and bad sweets, 3

Puzzles, 27

grow foods in your own garden, 11

and HIV, 189

pregnant women need Vitamin C, 16

R

tooth pain can interfere with nutrition, 62

Nystatin, 105, 181, 202

Records, 212, 220

Reports, 213, 220

Rinsing the mouth

during pregnancy, 16

O

with hydrogen peroxide, 8, 179

Oil

with salt water, 7, 178

prevents rust when sterilizing instruments, various rinses, 178-179

87

Root of the tooth, 41

Oil of cloves, 145

broken: diagnosis and treatment, 165

count roots before taking out a tooth, 159

P

has a nerve and blood vessel, 46

pushed into sinus, 166

Pain

Root fibers, 41, 220

aspirin or acetaminophen can help, 94

mouth and throat, 189

Patches (red or purple) in the mouth, 188

S

Penicillin, 93-94, 202-204

almost always taken by mouth, 93

Safe disposal of dental waste, 199-200

dental kit supply, 202

Safer sex, 191-192

dose taken by mouth, 94, 202

Salivary gland (spit gland) injectable,

204

infection in: diagnosis and treatment, 119
precautions,

203

Salt water rinse, 7, 178

take entire dose, 93, 203

Scalers, 128

Permanent teeth, 43, 54, 220

Scaling teeth, Chapter 8

knocked out: diagnosis and treatment, 97

instruction for after you scale teeth, 133-134

need good baby teeth before them, 64

instruments for, 128, 207

Phenytoin (See Dilantin) only scale teeth of someone who will keep teeth clean, 127

Index S-T

‘Scatter!’ (game), 50-51

Sweet foods, 9, 46, 55

School

avoid fizzy drinks, 11

cleaning teeth can be a daily health activity, can cause cavities and gum disease, 6-7

59-60, 205

learning activities, 48

school lunch program, 57

some are called ‘go foods’, 67-68

(Also
see

Teaching)

Swelling

Scientific method for making diagnosis, 76

and epilepsy medicine, 115

Sewing up a wound (suturing), 161-163

and pregnancy, 102

Sharpening stone, 128

after extractions, 116, 166

Shots (See Injections) different problems come at different ages, Sinus

78

infected, diagnosis and treatment, 95

from a tooth abscess, 6, 47

root pushed into sinus, 166

heat can lower swelling, 94

Slides for teaching about dental health, 215

may be a new molar coming in, 66

Socket, 220

possible causes (chart), 81

broken root inside, 165

Syringes

painful (dry socket): diagnosis and treatment, aspirating, 136, 207

117

for injections: two kinds, 135-136
painful,

167

(Also see Injections)

Soreness in mouth, possible causes (chart), 82

Sores

at corners of mouth: diagnosis and T
treatment, 107

Tartar, 52, 221

different problems come at different ages, 78

can be a sign of gum disease, 79

from a denture: diagnosis and treatment, how to scale, 129

106

makes gums sore, 8

on the face, 120

Teachers

on lips, cheek, and tongue, 74, 182

can teach without dental worker’s help, 36

types of face sores (chart), 83

Teaching

types of mouth sores (chart), 82, 182

‘association of ideas’, 14

Spatula, for cement fillings, 145

by example, 57, 193-194

Spit gland

community can be part of classroom, 25

infection in: diagnosis and treatment, 119

Spoon

each person can teach another, 12

for extractions, 155

finding the best way to teach, 13-18

for fillings, 145

finding the best place to teach, 17

making your own, 210

learn from the people, 13

let students discover for themselves, 20, 24

Sterilization, 87-89, 211

repetition helps people remember, 17

with steam, 88

teach yourself before teaching others, 2, 195

Story telling, 15, 26

teaching family and friends, Chapter 2

about pregnancy and dental care, 15-16

teaching school children, Chapters 3, 4

Sugar

teaching so that learning can happen, 20-24

some kinds make acid more easily, 55

with demonstrations, 26

sugar cane is not as bad as candy, 9

with drama, 26

(Also see Sweet foods)

with posters and pictures, 28

Sulfadimidine, 123

with puzzles, 27

Surveys, 214, 221

with story telling, 15-16, 169-170

as a way of learning numbers, 24, 25

(Also see School)

counting cavities, 49, 214

counting teeth, 44-45

to find the best way to clean teeth, 58

Sutures, 161-162

Index T-V-W-X-Z

Teeth

Treatment, Chapter 7
and gums, 1

can be given during pregnancy, 15-16, 77, broken, 96

102, 154
four problems to watch for, 73

early treatment prevents serious problems, 2
how many teeth we should have, 43

Trench mouth:

importance of, 1, 37

diagnosis and treatment, 102, 183
injuries to: diagnosis and treatment, 96-98

Tumor, diagnosis and treatment, 125
learning about anatomy, 49

Tweezers, how to make, 209
loose: diagnosis and treatment, 54, 99
naming teeth with numbers, 212
new tooth coming in:

diagnosis and treatment, 100, 101

V
rotting in cola drink (experiment), 48

Vegetable soup (special drink) what holds teeth, 41

for those who cannot eat properly, 111
what makes teeth hurt, 46

Vincent’s Infection of the gums why some teeth look different, 39

can worsen and become noma, 121-124

(Also see Baby teeth, Loose teeth) diagnosis and treatment, 102-103, 183-184

Teeth, false, 163-164

Vitamin C, 16

(Also see Dentures)

Teeth, taking out, Chapter 11

(Also see Extractions)

W

Teething: diagnosis and treatment, 101

Tension

Wax, to replace a knocked-out tooth, 98
can cause pain in joint, 114-115

Wire ligature, 110

Tetanus

Wisdom teeth (3rd Molars) (See Molars) diagnosis, 118

Tetracycline, can hurt baby teeth, 63, 202

Theater, 26

X

Thrush: diagnosis and treatment, 105, 180-181

Tongue blade (tongue depressor), 75, 206

X-rays

Tools (See Instruments) for knocked-out teeth, 98

Tooth (See Teeth)

to look at new tooth growing in, 100

Tooth abscess (See Abscess) warning about pregnant women, 77

Toothache
possible causes (chart), 80

Z
why teeth hurt, 46

(Also see Abscess)

Zinc oxide, 145, 205

Toothbrushes
how to make your own, 4-5, 23
how to make a brush smaller for a child, 63
soft is best, 4

Tooth decay
can touch nerve and cause an abscess, 6
flip chart presentation, 30

(Also see Cavities)

Tooth injuries
broken tooth: diagnosis and treatment, 96
tooth knocked out: diagnosis and treatment 97-98

Toothpaste, 5, 69

Tracing pictures, 31

Traditional beliefs, 10, 13, 221
about pregnancy, 15
building new traditions from old ones 14

Treadle-powered dental drill, 151

Other Books from Hesperian

Table of Contents

- CHAPTER 1
- CHAPTER 2
- CHAPTER
- CHAPTER 4
- CHAPTER 5
- part of your
- CHAPTER 6
- CHAPTER 7
- CHAPTER 8
- part of the tartar stays on
- CHAPTER 9
- CHAPTER
- CHAPTER 11
- CHAPTER