Periodontal
disease affects the tissues that both surround and support the tooth. The
disease is characterized by bleeding or swollen gums (gingivitis), pain and
sometimes bad breath. In its more severe form, the gum can come away from the
tooth and supporting bone, causing teeth to become loose and sometimes fall
out. Severe periodontal diseases are estimated to affect around 14% of the
global adult population, representing more than one billion cases worldwide.
The main causes of periodontal disease are poor oral hygiene and tobacco use.
Oral
cancer includes cancers of the lip, other parts of the mouth and the
oropharynx. The global incidence of cancers of the lip and oral cavity is
estimated at 4 cases per 100 000 people. However, there is wide variation
across the globe, from 0 to around 22 cases per 100 000 people. Oral cancer is
more common in men and in older people, and it varies strongly by
socio-economic condition.
Tobacco,
alcohol and areca nut (betel quid) use are among the leading causes of oral
cancer. In North America and Europe, human papillomavirus infections are
responsible for a growing percentage of oral cancers among young people.
Oro-dental
trauma results from injury to the teeth, mouth and oral cavity. Around 20% of
people suffer from trauma to teeth at some point in their life. Oro-dental
trauma can be caused by oral factors such as lack of alignment of teeth and
environmental factors (such as unsafe playgrounds, risk-taking behaviour, road
accidents and violence). Treatment is costly and lengthy and sometimes can even
lead to tooth loss, resulting in complications for facial and psychological
development and quality of life.
Noma
is a severe gangrenous disease of the mouth and the face. It mostly affects
children aged 2–6 years suffering from malnutrition, affected by infectious
disease, living in extreme poverty with poor oral hygiene or with weakened
immune systems.
Noma
is mostly found in sub-Saharan Africa, although cases have also been reported
in Latin America and Asia. Noma starts as a soft tissue lesion (a sore) of the
gums, inside the mouth. The initial gum lesion then develops into an acute
necrotizing gingivitis that progresses rapidly, destroying the soft tissues and
further progressing to involve the hard tissues and skin of the face.
According
to latest estimates (from 1998) there are 140 000 new cases of noma annually.
Without treatment, noma is fatal in 90% of cases. Survivors suffer from severe
facial disfigurement, have difficulty speaking and eating, endure social
stigma, and require complex surgery and rehabilitation. Where noma is detected
at an early stage, its progression can be rapidly halted through basic hygiene,
antibiotics and improved nutrition.
Orofacial
clefts, the most common craniofacial birth defects, have a global prevalence of
between 1 in 1000-1500 births with wide variation in different studies and
populations. Genetic predisposition is a major cause. However, poor maternal
nutrition, tobacco consumption, alcohol and obesity during pregnancy also play
a role. In low-income settings, there is a high mortality rate in the neonatal
period. If lip and palate clefts are properly treated by surgery, complete
rehabilitation is possible.
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