Periodontol 2000. 2012 Oct;60(1):147-55. doi: 10.1111/j.1600-0757.2011.00426.x.
Periodontal diseases are highly prevalent, particularly amongst socially disadvantaged populations, impact on quality of life and are costly to treat. Clinical treatments and chairside preventive approaches alone will never adequately address this problem. Indeed in many parts of the developing world clinical care and chairside prevention are both unaffordable and inappropriate for the control of periodontal diseases. A paradigm shift away from the individualized treatment approach to a population public health model is needed to promote periodontal health and, in particular to address social inequalities in periodontal status. Public health measures need to focus on the underlying determinants of periodontal diseases. Poor hygiene, tobacco use, psychosocial factors and related systemic diseases are the main risk factors for periodontal diseases. Public health interventions need to tackle these factors but also must recognize and act upon the distal underlying influences that determine and pattern these identified risks. Recognition also needs to be placed on the interlinking and common risk factors shared by periodontal diseases and other chronic conditions. A complementary range of public health policies acting at local, regional, national and international levels need to be implemented to achieve sustainable improvements in oral health. To be effective these policies need to link across the broader public health agenda and require public engagement and support. Clinicians, public health practitioners, commercial organizations and professional groups all have an important role to play in promoting periodontal health.
牙周病患病率极高，尤其是在社会弱势群体中，它会影响生活质量，且治疗费用昂贵。单纯的临床治疗和椅旁预防措施永远无法充分解决这个问题。事实上，在发展中国家的许多地区，临床护理和椅旁预防在控制牙周病方面既负担不起，也不适用。需要从个体化治疗模式向人群公共卫生模式转变，以促进牙周健康，特别是解决牙周状况的社会不平等问题。公共卫生措施需要关注牙周病的潜在决定因素。不良的卫生习惯、吸烟、社会心理因素和相关的系统性疾病是牙周病的主要危险因素。公共卫生干预措施需要解决这些因素，但也必须认识到并针对决定和形成这些已确定风险的潜在深远影响采取行动。还需要认识到牙周病和其他慢性疾病之间共同的、相互关联的风险因素。需要在地方、区域、国家和国际各级实施一系列互补的公共卫生政策，以实现口腔健康的可持续改善。为了有效实施这些政策，需要在更广泛的公共卫生议程中建立联系，并需要公众的参与和支持。临床医生、公共卫生从业者、商业组织和专业团体在促进牙周健康方面都发挥着重要作用。
