- In relation to oral health, discuss Barriers to Treatment and Prevention and Risk Factors from a global perspective. What are the nuances related to these barriers from resource rich and resource poor settings?
- What are China’s primary STRENGTHS (S); WEAKNESSES (W); OPPORTUNITIES (O); AND THREATS (T) (SWOT Analysis).
- What is one nurse-led “nudge” that will promote addressing the identified barriers and prevention to oral health in China.
Seven oral diseases and conditions account for most of the oral disease burden globally: Dental caries (tooth decay), Periodontal (gum) diseases, Oral cancers, Oral manifestations of HIV, Oro-dental trauma, Cleft lip and palate, and Noma.
These diseases and conditions are either largely preventable or can be treated in their early stages. Oral diseases were estimated by Global Burden of Diseases (GBD) in 2019 to have affected at least 3.48 billion people worldwide in 2019. An estimated 2.3 billion people suffered from caries of permanent teeth, the most prevalent of all conditions, and almost 530 million children suffered from caries of primary teeth. In fact, “oral disorders,” as they are called in GBD 2019, are among the most common of the noncommunicable diseases. Oral diseases were the 10th leading cause of years of life lived with disability (YLD) globally, for all ages and both sexes, in 2019. Oral disorders were the 9th leading cause of YLD globally for people 50 to 69 years of age and the 10th for people over 70 years of age. Despite the enormous amount of disability related to oral disorders, such disorders have never been part of mainstream discussions of global health. Dental caries and periodontal disease are two prominent but often neglected burdens of disease in low- and middle-income countries. Dental caries, commonly known as tooth decay or cavities, are present in 90 percent of the global population including an estimated 60 percent to 90 percent of all school-aged children worldwide. Caries result when naturally occurring oral bacteria break down foods, particularly those containing sugars and starches, into acidic by-products. These acids combine with saliva and food remnants to form plaque, a substance that builds up and adheres to teeth. Without removal, the plaque acids will either degrade the enamel of teeth and create cavities or turn into tartar, which can be removed only with a professional dental cleaning. Together, plaque and tartar cause gingivitis, or inflammation of the gums. When left untreated, gingivitis advances to periodontitis, a disease characterized by inflammation around the teeth and gums that retract from teeth. Once infection occurs, the body’s immune system responds with bacterial toxins that break down the bone and connective tissue, resulting in tooth loss. Severe forms of periodontal disease affect 5 percent to 15 percent of most populations including about 2 percent of youth worldwide. Many people underestimate the importance of oral health to children’s health. Both dental caries and periodontal disease contribute to childhood morbidity and have a negative impact on their quality of life. Oral health issues lead to school absenteeism. Malnutrition prevalence rates also increase if children are too pained to eat. A child’s psychosocial well-being and ability to smile and speak may also be impaired. Another oral health disease of importance is Noma. This condition originates as an untreated gingival inflammation, which then evolves into a gangrenous lesion that causes necrosis of the lips, chin, and facial tissues. Noma has generally been reported in children ages 2 to 6 who reside in low- income communities with poor sanitation in sub-Saharan Africa. It has also been reported in Asia and Latin America. The progression of Noma can be halted when it is detected and treated at an early stage. Such treatment would include good hygiene, antibiotics, and nutritional rehabilitation. Yet, it has been estimated that 90 percent of children who are exposed to this illness die because of receiving no medical care and survivors often cope with severe facial disfigurement.