when there is no dentist.pdf

Where There Is

No Dentist

by Murray Dickson

updated and expanded

with information about HIV and AIDS

by Richard Bebermeyer,

Martin Hobdell and Gene Stevenson

Introduction by David Werner,

author of Where There Is No Doctor

Berkeley, California, USA

www.hesperian.org

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or all parts of this book, including the illustrations, provided that the parts reproduced

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Library of Congress

Catalog card No. 82-84067

Dickson, Murray

Where there is no dentist.

Includes index.

Berkeley, CA: Hesperian Foundation

ISBN: 978-0-942364-05-7

First edition, November 1983

13th printing (updated), September 2010

Printed in Canada on acid-free, 100% recycled paper by Transcontinental

100%

Hesperian

1919 Addison St., #304

Berkeley, California 94704

USA

tel: 1-510-845-1447

fax: 1-510-845-9141

bookorders @ hesperian.org

www.hesperian.org

THANKS

Where There Is No Dentist, updated edition, 2010

Thanks from Hesperian

We continue to be inspired by Murray Dickson and his tireless efforts to

encourage health and dental promoters and community members to respond

self-reliantly to their health needs. A few years ago, Murray introduced us to

Richard Bebermeyer, Martin Hobdell, and Gene Stevenson, whom we thank for

volunteering their time to write and develop the manuscript for Chapter 12 in

this book, “HIV and Care of the Teeth and Gums.” That material was originally

published in 2002 and distributed as a supplement to the previous edition of

Where There Is No Dentist . We also thank Jane Maxwell, who edited the

supplement with assistance from Darlena David, Julie Gerk, and Todd Jailer.

Hesperian is lucky to be able to draw upon a large pool of people committed

to grassroots health, and we owe a debt of gratitude for their insightful

comments and suggestions to: Jean Arthur, Alma Carolina Blanco Reyes,

Claire Borket, Roman Carlos, Stephen Cox, Belinda Forbes, Jo Frencken,

Monica Gandhi, Gene Gowdey, Gerardo Gutiérrez, Martin Hobdell, Marie

Klaipo Patcharin Lekswat, Brian Linde, Theresa Noe, Francina Lozada Nur,

Stephen Moses, Foluso Owotade, Francis Serio, Michael Terry, Garth von

Hagen, and P. Wanzala.

New illustrations in this edition of the book are by: Silvia Barandier, Sara

Boore, Heidi Broner, José de Jesús Chan, Gil Corral, Regina Faul-Doyle, Anna

Kallis, Susan Klein, Gabriela Nuñez, Mona Sfeir, Sarah Wallis, Lihua Wang, and

Mary Ann Zapalac.

Editing and updating of the 2006 edition was coordinated by Kathleen Vickery

with assistance from Todd Jailer and Susan McCallister, production by Iñaki

Fernández de Retana and Leana Rosetti, and additional writing by Fiona

Thomson. For the 2010 edition, coordination by Dorothy Tegeler, with support

from Deborah Bickel, Matthew Crimp, Jacob Goolkasian, Shu Ping Guan, Todd

Jailer, Susan McCallister, and Kathleen Tandy.

Thanks from Murray Dickson, 1983

Where There Is No Dentist is here to ill a need. To many people, it has

seemed that the existing books about dental care were either too incomplete

or too complicated. If this book ills that need, it is only because a number of

people worked hard to make it happen. To them I owe my sincere thanks.

Much has happened since that day in Papua New Guinea when David

Werner’s letter arrived. His challenge was simple: “Since no one else

has written a dental manual like this, why don’t you?” With David’s

encouragement and constant support, I was able to take teaching notes and

produce a suitable draft that was the basis for this book. To you, David, for

your patience in helping me learn, my heartfelt thanks. Thanks also to Trude

Bock and Bill Bower for the home, food, direction, and support, during a short

visit to The Hesperian Foundation in which the book took a deinite turn for the

better.

Michael Blake deserves special mention. As editor of Where There Is No

Dentist, it was he who took the manuscript and nursed it along to completion.

Michael’s commitment to inishing the book was vital, and I sincerely

appreciate it.

My thanks go to Maggie Leung for typing the inal draft, and to those

dedicated persons who helped get the book into inal form: Annaloy Nickum

(page design); Hal Lockwood (typesetting and paste-up); Paul Chandler,

Serena Clayton, and Elaine Rossi (proofreading); Pat Bernier (typing); and

Howard Uno (photostats).

For their outstanding drawings, I am exceedingly grateful to: June Mehra,

Janet Elliott de Jacques, Michael Marzolla, Joan Thornpson, Mindy Mead,

Arlene Ustin-Cartagena, and Lynn Gordon. My own drawings in the manual

appear amateurish in comparison.

I want to thank the many persons who reviewed the manuscript and offered

valuable suggestions: Ken Cripwell, Bill Bower, Jeff Vore, Aaron Yaschine,

Rosalie Warpeha, Norma Francisco, Mike Muller, Marcia Anderson, Phil

Haskett, Bert Bali, Tom Coles, Sunil Mehra, and John Rogers. In particular,

thanks to Chris Lennox who, faced with stressful times in Papua New Guinea,

found time to read through two drafts; and to David Morley for his ideas for

improving the book and his assistance with its eventual publication.

For their inancial help, I am grateful to the Ella Lyman Cabot Trust, Muttart

Foundation, the Canadian Organization for Development through Education,

and the James C. Penney Foundation.

I thank the C.V. Mosby Company and Dr. Kenneth Snawder for permission to

adapt several drawings from the Handbook of Clinical Pedodontics, and the

Medical Missionary Association (244 Camden Road, London NW1 9HE, U.K.)

for permission to use parts of David Halestrap’s book Simple Dental Care.

This book is based upon several years of practical experience, made possible

by the Canadian Organization CUSO. For this opportunity, and for CUSO’s

active interest and involvement in this book, I most gratefully say thanks.

Finally, I want to acknowledge my family’s contribution. For weeks on end,

my wife, Gerri, faithfully read and discussed with me each part of the book

as it changed and was rewritten. She did this cheerfully, at a time when she

was fully occupied in a graduate study program. For much longer than I had

anticipated, Gerri and our two boys, Michael and Brennan, had to tolerate my

preoccupations.

My parents endured my wanderings and search for answers to human

problems with love and a growing sense of understanding. It is my only

disappointment that they did not live to see this book in its inal form.

CONTENTS

Introduction by David Werner

Part One: Learning and Teaching about Teeth and Gums

Chapter 1: Your Own Teeth and Gums . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Eat only good healthy foods . . . . . . . . . . . . . . . . . . . . 3

Clean your teeth every day . . . . . . . . . . . . . . . . . . . . . 4

Cavities, toothaches and abscesses . . . . . . . . . . . . . 6

Sore bleeding gums. . . . . . . . . . . . . . . . . . . . . . . . . . . 7

More serious gum disease . . . . . . . . . . . . . . . . . . . . . 8

Chapter 2: Teaching Family and Friends in Your Community . . . . . . . . . . . . . . 9

Chapter 3: Teaching Children at School. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

Chapter 4: School Activities for Learning about Teeth and Gums . . . . . . . . . . 35

Why do we need teeth and gums?. . . . . . . . . . . . . . 37

Why do some teeth look different? . . . . . . . . . . . . . 39

What holds the teeth?. . . . . . . . . . . . . . . . . . . . . . . . 41

How often do teeth grow in? . . . . . . . . . . . . . . . . . . 43

What makes teeth hurt? . . . . . . . . . . . . . . . . . . . . . . 46

How do germs make holes in the teeth? . . . . . . . . . 50

What makes the gums feel sore?. . . . . . . . . . . . . . . 52

What does it mean if a tooth is loose? . . . . . . . . . . 54

How can we prevent cavities and

sore gums? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55

Chapter 5: Taking Care of Teeth and Gums. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61

Part Two: Treating Dental Problems

Chapter 6: Examination and Diagnosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73

Where to examine . . . . . . . . . . . . . . . . . . . . . . . . . . . 75

The instruments you need. . . . . . . . . . . . . . . . . . . . . 75

A good diagnosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76

Learn to tell similar problems apart . . . . . . . . . . . . . 80

Chapter 7: Treating Some Common Problems . . . . . . . . . . . . . . . . . . . . . . . . . . . 85

The irst rule of treatment: stay clean! . . . . . . . . 86

Problems you will see most often . . . . . . . . . . . 92

Cavities . . . . . . . . . . . . . . . . . . . . . . . . . . 92

Abscess . . . . . . . . . . . . . . . . . . . . . . . . . . 93

Infected sinus . . . . . . . . . . . . . . . . . . . . . . 95

Tooth injuries. . . . . . . . . . . . . . . . . . . . . . . 96

Loose tooth . . . . . . . . . . . . . . . . . . . . . . . . 99

New tooth growing in . . . . . . . . . . . . . . . . .100

Gum disease . . . . . . . . . . . . . . . . . . . . . . .101

Fever blisters . . . . . . . . . . . . . . . . . . . . . . .104

Thrush . . . . . . . . . . . . . . . . . . . . . . . . . . .105

Canker sores . . . . . . . . . . . . . . . . . . . . . . .106

Some special problems . . . . . . . . . . . . . . . . . .108

Broken bone. . . . . . . . . . . . . . . . . . . . . . . .108

Dislocated jaw . . . . . . . . . . . . . . . . . . . . . .113

Pain in the joint. . . . . . . . . . . . . . . . . . . . . .114

Swollen gums and epilepsy . . . . . . . . . . . . .115

Blood in the mouth . . . . . . . . . . . . . . . . . . .116

After you take out a tooth . . . . . . . . . . . . . . . .116

Swelling of the face . . . . . . . . . . . . . . . . . .116

Pain from the socket . . . . . . . . . . . . . . . . . .117

Bleeding from the socket . . . . . . . . . . . . . . .118

Tetanus . . . . . . . . . . . . . . . . . . . . . . . . . . . .118

Infection in the spit (saliva) gland. . . . . . . . . . . .119

Sores on the face . . . . . . . . . . . . . . . . . . . . . .120

Noma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .121

Tumor. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .125

Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . .125

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