A report by the World Health Organisation on a global overview of oral health found that in spite of improvements, problems still persisted both in developed and developing countries, and were particularly prevalent amongst underprivileged groups.
Although preventative and curative oral healthcare is available here in North America, not everyone has sufficient coverage. Certain groups, such as the elderly or disabled, do not necessarily have access to affordable dental care. The problem is the shortage of oral health personnel. The majority of oral health services are offered from regional or central hospitals, and the lack of resources means little attention is given to preventative and restorative dental care.
The global prevalence of periodontal disease plays a significant role in oral disease, yet most oral healthcare providers and the general public fail to give it the attention it deserves. The purpose of the WHO report was to put the incidence of periodontal disease into perspective globally, as well as looking at strategies to prevent and control this disease.
In order to assess the worldwide prevalence of periodontal disease, the WHO introduced the Community Periodontal Index (CPI), which measures the presence and severity of gum disease, giving a profile of periodontal health within separate countries. This index enables counties to plan intervention and control programs more effectively, and is easily replicated, allowing for comparisons to be made.
In 1997, at the suggestion of WHO, the CPI began to include information on the loss of periodontal attachment, and correlated this loss to age. Not surprisingly, studies showed that periodontal disease was more dominant in older age groups.
The majority of epidemiologic studies carried out worldwide found clear links between socioeconomic status and periodontal disease. Poorly educated people, or those on a low income were more likely to have some form of periodontal disease, and one study by Drury et al found a 10% to 20% difference between lower and higher socioeconomic populations in the US.
As well as poor hygiene, other factors instrumental in developing periodontal disease include tobacco and alcohol use, poor diet, stress, and presence of systemic diseases such as diabetes, heart disease, cancer and strokes. An unhealthy lifestyle has a significant effect on periodontal disease.
One of the most important associations is between periodontal disease and diabetes, a systemic condition affecting 177 million people worldwide. It’s estimated this figure could double by 2030, due to the increase in obesity and unhealthy lifestyles, and diabetics can have a much higher incidence of periodontal disease, which often more severe and progresses rapidly.
The WHO is instrumental in providing a scientific basis for public health action. Its role is to detect, assess and monitor threats to public health and to provide assistance to communities and countries in developing effective oral health programs. Its strategy for improving periodontal health is to ensure that countries gain better control of chronic diseases, and to promote a healthy lifestyle and diet which doesn’t involve excess alcohol and tobacco use. This strategy also gives special priority to the increasing prevalence of diabetes, by making prevention of periodontal disease an integral part in the prevention and treatment of diabetes. To read the full report from the WHO, click here.