Global oral sundhed
Formålet med denne artikel er at give et overblik over den globale orale sygdomsbyrde for befolkninger, at belyse situationen i Europa og Norden, at understrege den universelle ulighed i oral sundhed og endelig at gøre rede for det globale sundhedsarbejde, som varetages af Verdenssundhedsorganisationen WHO.
Sygdom er en faktor, der begrænser menneskers livsudfoldelse og samfundets vækstmuligheder. Overalt i verden er orale sygdomme vigtige kroniske sygdomme, der påvirker menneskers generelle sundhed, funktion og velvære. Formålet med denne artikel er at give et overblik over den globale orale sygdomsbyrde for befolkninger, at belyse situationen i Europa og Norden, at understrege den universelle ulighed i oral sundhed og endelig at gøre rede for det globale sundhedsarbejde, som varetages af Verdenssundhedsorganisationen WHO. Datagrundlaget hidrører fra databaser i WHO; WHO-publikationer og databaser for videnskabelig faglitteratur. Globalt set er 60-90 % af børn og næsten alle voksne ramt af caries; carieserfaringen især hos børn er kraftigt på retur i højindkomstlande, men derimod hastigt stigende i lav- og mellemindkomstlande. De fleste mennesker i verden har parodontale sygdomssymptomer; i alle regioner af verden har omkring 5-20 % af yngre voksne alvorlig marginal parodontitis, hvilket er en trussel for tandtab. Henved 25 % af verdens befolkning i alderen 65-74 år er tandløse; tandløshed er på retur i højindkomstlande, mens tilstanden er på fremmarch i lav- og mellemindkomstlande uden systematisk tandpleje. Social ulighed i oral sundhed er universel, ligeså for søgning af tandpleje, idet høj brugerbetaling er en barriere for tandpleje. De fleste mennesker i udviklingslande er afskåret fra essentiel tandpleje; også i Europa modtager socialt dårligt stillede befolkningsgrupper ikke optimal tandpleje. Tandsundheden i Østeuropa er dårligere end i Vesteuropa. Prævalensen af oral cancer er især høj i Asien, men også betydende i Nordamerika og Europa. Orallæsioner relateret til HIV-infektion er hyppigt forekommende i Afrika og Sydøstasien, hvor også noma findes i ekstremt fattige miljøer. Populationsrettet forebyggelse baseret på reduktion af fælles risikofaktorer for kroniske sygdomme er vigtig for kampen mod den voksende byrde af orale sygdomme, og det er samtidig nødvendigt at styrke det sundhedsfremmende arbejde. WHO spiller en afgørende rolle i udvikling af bæredygtige folkesundhedsprogrammer for oral sundhed for alle.
Oral health in a global perspective – status and strategies for continuous promotion of health Disease and illness are factors which impact on people’s life chances and society achievements. Oral diseases and conditions are important to general health and quality of life. The purpose of this report is to provide an overview of the global burden of oral disease, to highlight the situation in Europe and the Nordic countries, to underscore the universal inequities in oral health, and to outline the work for global oral health undertaken by the World Health Organization (WHO). The report makes use of information from WHO databases, WHO publications, and databases of scientific literature. Globally 60-90% of children and the vast majority of adults are affected by dental caries;it is worth noting, however, that caries in children has declined markedly over the past decades in certain high income countries, while the disease burden is growing rapidly in low- and middle income countries. Poor periodontal health afflicts nearly all populations around the globe; across regions 5 to 20 % of younger adults (35-44 years) have signs of severe periodontal disease which increases the risk of tooth loss. Around 25% of the world population aged 65-74 years has lost all their natural teeth.Edentulism has recently declined in high income countries, but is on the increase in those low and middle income countries without systematic oral health programmes. Huge variations in the burden of dental disease are found between countries and regions of the world. Dental caries of children and adults is frequent in Europe but low in Africa. Within Europe, oral health conditions in Eastern Europe are poor when compared to Western Europe. The prevalence of oral cancer is high, particularly in South-East Asia, which relates to the high consumption of tobacco including smokeless tobacco. Oral lesions related to HIV infection and noma are prevalent in Africa and South-East Asia. Social inequities in oral health are universal and imply that people of low education and poor income carry significantly higher disease burden than wealthy population groups. Besides, underprivileged people in developing and developed countries are not covered effectively by primary oral health care; this is also the case in Europe – even in the rich Nordic countries- where the underprivileged population groups do not benefit adequately from optimal oral health care and disease prevention. Oral diseases are the most important chronic disease. Public health initiatives against chronic diseases are urgently needed across the world. Population-directed disease prevention based on risk factor approaches and health promotion are essential for countries in order to reduce the growing burden of chronic diseases, including oral diseases. WHO plays a vital role in the development of policies for health of all, particularly within the framework of Health-in-All policies.
