Periodontol 2000. 2012 Oct;60(1):15-39. doi: 10.1111/j.1600-0757.2011.00425.x.
Chronic diseases are accelerating globally, advancing across all regions and pervading all socioeconomic classes. Unhealthy diet and poor nutrition, physical inactivity, tobacco use, excessive use of alcohol and psychosocial stress are the most important risk factors. Periodontal disease is a component of the global burden of chronic disease, and chronic disease and periodontal disease have the same essential risk factors. In addition, severe periodontal disease is related to poor oral hygiene and to poor general health (e.g. the presence of diabetes mellitus and other systemic diseases). The present report highlights the global burden of periodontal disease: the ultimate burden of periodontal disease (tooth loss), as well as signs of periodontal disease, are described from World Health Organization (WHO) epidemiological data. High prevalence rates of complete tooth loss are found in upper middle-income countries, whereas the tooth-loss rates, at the time of writing, are modest for low-income countries. In high-income countries somewhat lower rates for edentulism are found when compared with upper middle-income countries. Around the world, social inequality in tooth loss is profound within countries. The Community Periodontal Index was introduced by the WHO in 1987 for countries to produce periodontal health profiles and to assist countries in the planning and evaluation of intervention programs. Globally, gingival bleeding is the most prevalent sign of disease, whereas the presence of deep periodontal pockets (≥6 mm) varies from 10% to 15% in adult populations. Intercountry and intracountry variations are found in the prevalence of periodontal disease, and these variations relate to socio-environmental conditions, behavioral risk factors, general health status of people (e.g. diabetes and HIV status) and oral health systems. National public health initiatives for the control and prevention of periodontal disease should include oral health promotion and integrated disease-prevention strategies based on common risk-factor approaches. Capacity building of oral health systems must consider the establishment of a financially fair service in periodontal care. Health systems research is needed for the evaluation of population-oriented oral health programs.
慢性病在全球范围内加速蔓延，遍及所有地区和各个社会经济阶层。不健康的饮食和营养不良、缺乏身体活动、烟草使用、过量饮酒和心理社会压力是最重要的危险因素。牙周病是全球慢性病负担的一个组成部分，慢性病和牙周病有相同的基本危险因素。此外，严重的牙周病与口腔卫生不良以及整体健康状况不佳（例如糖尿病和其他全身性疾病）有关。本报告重点介绍牙周病的全球负担：根据世界卫生组织（世卫组织）的流行病学数据，描述了牙周病的最终负担（牙齿缺失）以及牙周病的迹象。在上中等收入国家，完全牙齿缺失的高患病率率较高，而在低收入国家，牙齿缺失率在撰写本文时处于适度水平。在高收入国家，与上中等收入国家相比，无牙率的比率较低。在全球范围内，国家内部的牙齿缺失存在严重的社会不平等现象。1987 年，世卫组织推出了社区牙周指数，用于各国制作牙周健康档案，并协助各国规划和评估干预方案。在全球范围内，牙龈出血是最常见的疾病迹象，而深牙周袋（≥6 毫米）的存在在成年人群中从 10%到 15%不等。牙周病的患病率在国家间和国家内存在差异，这些差异与社会环境条件、行为危险因素、人们的一般健康状况（例如糖尿病和艾滋病毒状况）以及口腔卫生系统有关。控制和预防牙周病的国家公共卫生倡议应包括口腔健康促进和基于共同危险因素方法的综合疾病预防策略。口腔卫生系统的能力建设必须考虑在牙周保健方面建立一个财务公平的服务。需要进行卫生系统研究，以评估面向人群的口腔卫生方案。
