Acute infectious oral necrosis among young children in the Gambia, West‐Africa

Among 7,650 patients who attended the oral surgery clinic in the Royal Victoria Hospital, Bathurst, Gambia, between February 1964 and March 1965, were 50 young children between the ages of 1 to 6 years who suffered from acute oral necrotizing diseases.These disease processes started with necrosis and ulceration of interdental papillae and often continued to the most severe stage of fulminating necrosis, frequently associated with death. The disease intensity was inversely related to the child's age. A search for oral factors contributing to this condition was made in a survey of the entire child population of 4 Gambian villages. 361 children, 1 week to 5 1/2 years old were examined. Poor oral hygiene and gingivitis were found to be common in these children. Food debris in various amounts were found in 71 per cent of the children over 18 months of age. Periodontal diseases were already found in 9 per cent of the 18 month-old children. In the 3 to 4 year age group, 61 per cent of the children suffered from periodontal diseases which often were of a chronic nature. Bacterial smears showed a high incidence of Vincent's organisms. Systemic factors apparently predisposing to the acute oral necrosis were improper nutrition, debilitation and lowered resistance brought about by endemic infectious diseases.