Global Oral Health Inequalities

Abstract

Four oral mucosal infections were identified as Global Oral Health Priorities: (a) HIV and associated viral, bacterial, and fungal infections; (b) tuberculosis; (c) NOMA; and (d) sexually transmitted diseases. Huge global inequalities exist in all four. HIV-associated infections constitute the major challenge. Oral manifestations of AIDS can be specifically diagnostic, indicating a significant role for dentists within health teams. The World Workshops in Oral Health & Disease in AIDS have identified a research program, elements of which are being implemented. Data on oral mucosal involvement in tuberculosis, syphilis, and gonorrhea are incomplete in developed countries and virtually non-existent in low- and middle-income countries, indicating the need for further epidemiological studies. Oral manifestations of tuberculosis and sexually transmitted diseases are largely associated with general health, so action programs should be integrated with agencies treating the systemic diseases. NOMA is very much in the oral health domain. It is a preventable disease associated with malnutrition and unidentified bacterial factors. Prevalence is probably grossly overestimated at present; but nevertheless it constitutes a challenge to the profession, especially in the NOMA belt. Current treatment is surgical, but plans for its eradication should be achievable. The global oral health community, especially the IADR, has a major role to play.

Management of noma: practice competence and knowledge among healthcare workers in a rural district of Zambia

“…As Challacombe et al [ 22 ] present, actions against noma can be taken on different levels. At the primary healthcare level, education of health personnel is one way to improve early recognition and referral of noma cases.…”

Multiple oral ulcers leading to diagnosis of pulmonary tuberculosis

“…[1] Tuberculosis can either be primary or secondary and can involve any part of the body. The oral cavity is an unusual site to be affected in tuberculosis and is generally due to secondary infection.…”

“…[2] Among these, ulcers and papillomas are the commonest form and usually present as single lesions. [1] Tuberculous ulcers involving multiple sites in the oral cavity are rare. Herein we report one such case with multiple oral ulcers as initial presenting complaint of tuberculosis.…”