Chronic conditions policies: oral health, a felt absence

Abstract

The global health scenario shows an epidemic of non-communicable diseases that lead to long-term chronic conditions, some of which are incurable. Many infectious diseases, owing to their development and length, also generate chronic conditions. Similarly, non-morbid states, such as pregnancy, and some life cycles such as adolescence and ageing, follow the same logic. Among all these chronic conditions there is a significant interrelationship with oral health, both in parallel events and common risk factors. This article presents cross-sectional qualitative research into World Health Organisation recommended health policies to address chronic conditions. Several documents published by the organisation were analysed to verify the presence of references to oral health in relation to chronic conditions, particularly cardiovascular diseases and diabetes as these most frequently have oral manifestations. The analysis showed no significant references to oral health or its indicators within the published texts. The study recognises the value of the work developed by the World Health Organisation, as well as its worldwide leadership role in the development of health policies for chronic conditions. This article proposes a coalition of dentistry organisations that could, in a more forceful and collective way, advocate for a greater presence of oral health in drafting policies addressing chronic conditions.

Tooth loss in middle-aged adults with diabetes and hypertension: Social determinants, health perceptions, oral impact on daily performance (OIDP) and treatment need

“…In this perspective, considering that many pathophysiological mechanisms explains the link between diabetes and hypertension ( 35 ), it is possible that individuals with these chronic conditions experienced tooth loss more severely than individuals with good systemic health ( 11 ). Some factors might be linked with tooth loss, explaining its incidence and severity through different and connected pathways: difficulties of access to health services ( 14 ), self-perceptions of oral health ( 15 ), the complexity of interactions between oral and systemic diseases ( 5 , 36 ), and social inequality in health ( 13 , 37 ). In this context, the knowledge about the cultural, historical and contextual factors associated with oral care and access to dental services might be a relevant point for research, providing more information relative to the better way to plan interventions in community and individual level.…”

“…Recently, the WHO worked on drafting policies addressing chronic conditions; however, these actions did not consider some aspects of fundamental care, including oral health ( 5 ). During the aging process, the cumulative nature of commonly reported oral diseases (dental caries and periodontitis) can promote a significant pattern of severity that culminates in tooth loss.…”

“…Previous studies have shown that oral health status is negatively related to hypertension ( 8 ) and diabetes ( 9 - 11 ), although the causality of these chronic diseases and oral health is controversial. Indeed, it is clear that there are common risk factors that link systemic conditions with oral health, such as the intake of sugar, tobacco, alcohol, low educational level, and poverty ( 5 ). Preliminary evidence has suggested that tooth loss was associated with socioeconomic status ( 12 , 13 ), ineffective access to dental services ( 14 ), and self-perceptions of health ( 15 ); however, the scientific literature does not provide any clear information regarding these factors in individuals with non-communicable diseases.…”

Clustering patterns of oral and general health‐risk behaviours in Brazilian adolescents: Findings from a national survey

“…[4][5][6] Nevertheless, increased attention on oral health in policies addressing chronic conditions is still to be advocated. 7 It is been documented in the literature that unfavourable behaviours tend to co-occur in adolescents, in the so-called problem behaviour syndrome. 1,8,9 This theory has been expanded to include health behaviours, because many unfavourable behaviours, such as alcohol use, marijuana use, unprotected sex and driving after drinking, can be considered health-compromising and contrary to social norms.…”

Inflammation Mediators Related to Periodontal Disease and Pregnancy Outcomes: A Call for Quality of Antenatal Care While Promising Evidences Are Emerging

“…A crucial implication from this refers to the health services and the healthcare delivery model that are put in operation. The chronic disease management cannot disregard the periodontal treatment as part of the health care when aiming at reaching an optimal level of quality compatible with current evidences (Schwab et al, 2014). In the antenatal care, recent guidelines have highlighted the importance of a comprehensive healthcare provision for the pregnant women standing out oral healthcare.…”