WHO releases new report on global problem of oral diseases
24 February 2004 | Geneva - Oral diseases such as dental caries (tooth decay), periodontitis (gum disease) and oral and pharyngeal cancers are a global health problem in both industrialized and increasingly in developing countries, especially amongst poorer communities, the World Health Organization (WHO) said today. Announcing the findings of the World Oral Health Report, WHO said that an estimated five billion people worldwide had experienced dental caries.
“Worldwide, losing teeth is seen as a natural consequence of ageing, but it is in fact preventable,” said Dr Catherine Le Gales-Camus, WHO’s Assistant-Director General, Noncommunicable Diseases and Mental Health. “There is a perception that dental caries is no longer a problem in the developed world, but it affects 60-90% of schoolchildren and the vast majority of adults. Dental caries is also the most prevalent oral disease in several Asian and Latin American countries.”
The impact of oral diseases in pain, suffering, impaired function and reduced quality of life, is both extensive and expensive. Treatment is estimated to account for between 5-10% of health costs in industrialized countries, and is beyond the resources of many developing countries.
While it appears to be less severe in most African countries, the report states that with changing living conditions, dental caries is expected to increase in many developing countries in Africa, particularly as a result of the growing consumption of sugars and inadequate exposure to fluorides.
“In many developing countries, access to oral health care is limited and teeth are often left untreated, or extracted,” said Dr Poul Erik Petersen, coordinator of WHO’s Global Oral Health Programme. “In Africa, the dentist-to-population ratio is approximately 1:150,000, against about 1:2,000 in most industrialized countries. And while we have made limited progress in reducing tooth decay amongst younger people in the developed world, for many older people it remains a major source of pain and ill-health.”
Globally, most children shows signs of gingivitis (bleeding gums) and among adults, the initial stages of periodontal disease are prevalent. Severe periodontitis, which may result in tooth loss, is found in 5-15% of most populations. In industrialized countries, studies show that smoking is a key risk factor for periodontal disease.
The prevalence of oral cancer is the eighth most common cancer of men worldwide. In south central Asia, cancer of the oral cavity ranks amongst the three most common types of cancer. However, sharp increases of oral/pharyngeal cancers have also been reported for several countries and regions such as Denmark, Germany, Scotland, central and eastern Europe, and to a lesser extent, Australia, New Zealand, Japan and the USA. Smoking, smokeless tobacco, chewing betel, and alcohol use, are all risk factors.
The major priorities and components of WHO’s Global Oral Health Programme are set out in the new report. In addition to addressing modifiable risks such as oral hygiene practices, sugar consumption, lack of calcium and micronutrients, and tobacco use, key elements include addressing the major sociocultural determinants. These include: poor living conditions, low education level, as well as lack of traditions supporting oral health. Countries should ensure appropriate use of fluorides for prevention of dental caries, while unsafe water and poor hygiene are environmental risk factors for oral as well as general health.
Oral health systems need to be oriented to primary health care and prevention. WHO’s Global School Health Initiative, which seeks to mobilize health promotion and education levels at local national, regional and global levels, has recently been strengthened by an oral health technical document. Increasing emphasis has also been placed on targeting the elderly; by 2050, there will be two billion people over the age of 60, 80% of them living in the developing world. The Oral Health Programme will also make an important contribution to the early diagnosis, prevention and treatment of HIV/AIDS, which often shows up first in oral fungal, bacterial or viral infections and lesions.
“Poor oral health can have a profound effect on general health and the quality of life,” said Dr Petersen. “The experience of pain, endurance of dental abcesses, problems with eating, chewing, and missing, discoloured or damaged teeth, has a major impact on people’s daily lives and wellbeing.”