The global burden of periodontal disease: towards integration with chronic disease prevention and control
The global burden of periodontal disease: towards integration with chronic disease prevention and control
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DOI：
10.1111/j.1600-0757.2011.00425.x
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发表时间：
2012-10-01
影响因子：
18.6
通讯作者：
Ogawa, Hiroshi
中科院分区：
文献类型：
--
作者：
Petersen, Poul E.;Ogawa, Hiroshi
慢性病在全球范围内加速蔓延，在所有地区蔓延并渗透到所有社会经济阶层。不健康的饮食和营养不良、缺乏身体活动、吸烟、过度饮酒和社会心理压力是最重要的危险因素。牙周病是全球慢性病负担的一部分，慢性病和牙周病具有相同的基本危险因素。此外，严重的牙周病与口腔卫生不良和整体健康状况不佳（例如糖尿病和其他全身性疾病）有关。本报告强调了牙周病的全球负担：世界卫生组织（WHO）流行病学数据描述了牙周病的最终负担（牙齿脱落）以及牙周病的迹象。在中高收入国家，牙齿完全缺失的发生率很高，而在撰写本文时，低收入国家的牙齿缺失率较低。与中高收入国家相比，高收入国家的无牙颌比率较低。在世界各地，各国内部牙齿缺失的社会不平等现象十分严重。世界卫生组织于 1987 年推出社区牙周指数，供各国编制牙周健康概况并协助各国规划和评估干预计划。在全球范围内，牙龈出血是最常见的疾病体征，而成年人群中存在深牙周袋（≥6mm）的比例从 10% 到 15% 不等。牙周病的患病率存在国家间和国家内的差异，这些差异与社会环境条件、行为风险因素、人们的一般健康状况（例如糖尿病和艾滋病毒状况）和口腔卫生系统有关。控制和预防牙周病的国家公共卫生举措应包括口腔健康促进和基于常见危险因素方法的综合疾病预防策略。口腔卫生系统的能力建设必须考虑在牙周护理方面建立财政上公平的服务。需要进行卫生系统研究来评估以人群为导向的口腔健康计划。
Chronic diseases are accelerating globally, advancing across all regions and pervading all socioeconomic classes. Unhealthy diet and poor nutrition, physical inactivity, tobacco use, excessive use of alcohol and psychosocial stress are the most important risk factors. Periodontal disease is a component of the global burden of chronic disease, and chronic disease and periodontal disease have the same essential risk factors. In addition, severe periodontal disease is related to poor oral hygiene and to poor general health (e.g. the presence of diabetes mellitus and other systemic diseases). The present report highlights the global burden of periodontal disease: the ultimate burden of periodontal disease (tooth loss), as well as signs of periodontal disease, are described from World Health Organization (WHO) epidemiological data. High prevalence rates of complete tooth loss are found in upper middle‐income countries, whereas the tooth‐loss rates, at the time of writing, are modest for low‐income countries. In high‐income countries somewhat lower rates for edentulism are found when compared with upper middle‐income countries. Around the world, social inequality in tooth loss is profound within countries. The Community Periodontal Index was introduced by the WHO in 1987 for countries to produce periodontal health profiles and to assist countries in the planning and evaluation of intervention programs. Globally, gingival bleeding is the most prevalent sign of disease, whereas the presence of deep periodontal pockets (≥6 mm) varies from 10% to 15% in adult populations. Intercountry and intracountry variations are found in the prevalence of periodontal disease, and these variations relate to socio‐environmental conditions, behavioral risk factors, general health status of people (e.g. diabetes and HIV status) and oral health systems. National public health initiatives for the control and prevention of periodontal disease should include oral health promotion and integrated disease‐prevention strategies based on common risk‐factor approaches. Capacity building of oral health systems must consider the establishment of a financially fair service in periodontal care. Health systems research is needed for the evaluation of population‐oriented oral health programs.