Challacombe S, Chidzonga M, Glick M, Hodgson T,
Magalhães M, Shiboski C, Owotade F, Ranganathan R, Naidoo S.
Oral Medicine, King's College London Dental Institute, Central Office, Floor
18, Guys Tower, Guys Hospital, London SE1 9RT, UK.
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. |