Pyorrhea a disease of the tooth and surrounding support tissue of the gum in which pus forms at the roots of the teeth. The disease is common in adults. It starts with the accumulation of tartar and debris of food just behind the gum margin. The gum gradually recedes and bacterial infection, usually with microaerophilic bacteria (partially oxygen dependent) takes place. Growth of bacteria and release of toxic and inflammatory metabolites cause chronic inflammation of the gum, pain and bleeding of the gum. Supporting bone tissue is slowly destroyed resulting in loosening of the tooth and eventual loss of tooth. Poor dental care is the main cause of the disease.

Proper brushing of teeth and removal of the formed tartar with dental floss are helpful in preventing the disease. Susceptibility to pyorrhea increases if the sequence of eruption of teeth is such that it causes faulty teeth alignment. Poorly aligned teeth favour increased accumulation of tartar and are difficult to keep clean.

The poor socio-economic condition of Bangladesh does not allow the vast majority of the rural people to use toothbrush and tooth paste. Instead the village people use ash to rub their teeth with their fingertips which may be harmful for both tooth enamel and gum. Plant twigs with one end thrashed to make it brush like are also commonly used to clean teeth. Twigs of the neem plant are particularly popular that can be purchased from the village market. Religious groups have long promoted the use of this device for good dental health. The emerging new scientific facts about the medicinal value of neem would appear to add credence to traditional wisdom of the villagers. [Zia Uddin Ahmed]