Abstract
Despite great improvements in oral health in the past decades, oral disease remains a major public health problem worldwide. The burden of oral disease is particularly high among the disadvantaged population groups in both developing and developed countries. The pattern of oral disease reflects distinct risk profiles across countries that are related to living conditions, lifestyles, environmental factors, and the availability and accessibility of oral health services. In several developing countries, people at large do not benefit from preventive oral health programmes. It is expected that the incidence of dental caries will increase in the near future in many of these countries as a result of growing consumption of sugars and inadequate exposure to fluorides. With the rising use of tobacco in developing countries, the risk of periodontal disease, tooth loss and oral cancer may therefore increase. Several oral diseases are linked to non-communicable chronic diseases or conditions that share common risk factors, such as diabetes, obesity and cancer. Similarly, general diseases often have oral manifestations (e.g. diabetes or HIV/AIDS).
Worldwide strengthening of public health programmes through implementation of effective oral disease prevention measures and health promotion is urgently needed, and use of common risk factors approaches should integrate oral health within national health programmes. The challenges to oral health improvement are particularly high in developing countries. The World Health Organization Global Oral Health Programme formulates policies and actions for the improvement of oral health, strategies that are fully integrated with chronic disease prevention and general health promotion. At the 60th World Health Assembly in 2007, the WHO Member States agreed on an action plan for oral health and integrated disease prevention, thereby confirming the approach of the Oral Health Programme. The policy forms the basis for future development of oral health programmes.
Zusammenfassung
Trotz großer Fortschritte, die im Bereich Mundgesundheit in den letzten Jahrzehnten gemacht wurden, bleiben Erkrankungen im Mundraum weltweit ein bedeutendes Public-Health-Problem. Besonders hoch ist die Krankheitslast in den sozial benachteiligten Bevölkerungsgruppen, sowohl in den Industriestaaten als auch in den Entwicklungsländern. Das Ausmaß oraler Erkrankungen reflektiert bestimmte Risikoprofile innerhalb der Länder, die sich auf die Lebensumstände, die Lebensart, auf Umweltfaktoren und die Verfügbarkeit sowie den Zugang zu einer zahnärztlichen Versorgung beziehen. In einigen Entwicklungsländern profitieren die Menschen größtenteils nicht von zahnmedizinischen Präventionsprogrammen. Es ist zu erwarten, dass sich die Inzidenz von Zahnkaries in näherer Zukunft in diesen Ländern als ein Resultat des ansteigenden Verzehrs von Zucker und der mangelhaften Aufnahme von Fluoriden erhöhen wird. Mit dem zunehmenden Konsum von Tabak in Entwicklungsländern dürfte das Risiko von Parodontalerkrankungen (Zahnfleischentzündungen), von Zahnverlust und Tumoren im Mundbereich zusätzlich ansteigen. Einige orale Erkrankungen stehen in engem Zusammenhang mit nicht übertragbaren chronischen Erkrankungen bzw. mit Erkrankungen, die bestimmte allgemeine Risikofaktoren aufweisen (common risk factors) wie beispielsweise Diabetes, Fettleibigkeit und Tumorerkrankungen. Gleichzeitig manifestieren sich Allgemeinerkrankungen oft im Mundraum (z. B. Diabetes oder HIV/Aids). Weltweit ist eine Stärkung von Public-Health-Programmen durch die Implementierung effektiver mundgesundheitsbezogener Maßnahmen der Prävention und Gesundheitsförderung dringend notwendig. Der auf gemeinsame Risikofaktoren ausgerichtete Ansatz macht eine Integration von Aspekten der Mundgesundheit in nationale Gesundheitsprogramme erforderlich.
Die Herausforderungen zur Verbesserung der Mundgesundheit sind besonders in den Entwicklungsländern hoch. Das „World Health Organisation Global Oral Health Programme“ formulierte Strategien und Vorhaben zur Verbesserung der Mundgesundheit sowie Strategien, die vollständig eingegliedert sind in die Prävention chronischer Erkrankungen und in die allgemeine Gesundheitsförderung. Auf der 60. Weltgesundheitsversammlung (WHA) im Jahre 2007 haben die Mitglieder der Weltgesundheitsorganisation (WHO) einen Aktionsplan zur Förderung der Mundgesundheit und zur integrierten Krankheitsprävention beschlossen, wodurch das „Oral Health Programme“ in seinen Inhalten bestätigt wurde. Die Strategien bilden die Basis für die zukünftige Entwicklung von Gesundheitsförderungsprogrammen im Bereich Mundgesundheit.
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Petersen, P., Kwan, S. World Health Organization global oral health strategies for oral health promotion and disease prevention in the twenty-first century. Praev Gesundheitsf 4, 100–104 (2009). https://doi.org/10.1007/s11553-009-0169-x
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DOI: https://doi.org/10.1007/s11553-009-0169-x