Resumo em Inglês:

Abstract The aim of this review was to update knowledge about the prevalence of periodontitis in Latin America and the Caribbean. A critical review of was performed of all cross-sectional or cohort studies selected, pertaining to the region, and thirty-five studies conducted in 12 countries were selected. The countries with nationally representative studies were Brazil, Chile, Colombia, and Uruguay. The prevalence of periodontal disease or need for periodontal treatment varied between the different studies and countries depending on the age group, the methodology used, and the case definition. The prevalence of severe periodontitis aged between 5.8% and 49.7% in adults. In adolescents, the prevalence of moderate to severe periodontitis was 15.3%. Furthermore, a high prevalence of gingival bleeding in adolescents was reported. When analyzing the studies that used the Community Periodontal Index (CPI), Centers for Diseases Control and American Academy Periodontology (CDC/AAP) case definition, it was observed that as the age of the individuals analyzed increased, the prevalence of periodontal disease also increased. Whereas this rereview revealed that although the number of regional and nationally representative studies that analyzed the prevalence of periodontitis has risen in recent years, their methodological heterogeneity prevents global conclusions to be drawn concerning the region. Therefore, this ratifies the need to generate alliances between countries with the purpose of joining individual efforts to achieve collective goals which, among other objectives, will translate into conducting multicenter studies. These studies would allow description and monitoring of the epidemiological behavior of periodontitis in Latin America and the Caribbean.

Resumo em Inglês:

Abstract Periodontal diseases are highly prevalent globally, and represent a significant public health burden that could affect the quality of life in Latin American and in Caribbean countries and territories. The primary objective is to explore the existing research and epidemiological studies on the burden of periodontal diseases, particularly their impact on oral health-related quality of life (OHRQoL) and associations with systemic health conditions in Latin America and the Caribbean (LAC). An electronic literature search was conducted across multiple databases, including MEDLINE (PubMed), Scopus, LILACS, SciELO, and Web of Science, without publication date or language limitations, up until December 2023. Reviewers independently assessed titles and abstracts based on the eligibility criteria. The search yielded 1195 articles, with 63 meeting the inclusion criteria. The results of epidemiological studies showed that periodontitis is extremely prevalent at 90% in LAC; severe periodontitis can affect nearly 10% of the adult population and that periodontitis is aggravated by smoking, poverty, low education level, and limited access to proper dental care. Periodontitis was consistently associated with worse OHRQoL; and causing pain, and/or triggering psychological discomfort, physical disability, and social disability. Associations were also reported between periodontitis and comorbidities such as diabetes, cardiovascular disease, rheumatoid arthritis, respiratory disease, mental illness, and adverse pregnancy outcomes that are also affecting the quality of life of individuals and their families. This scoping review offers a thorough examination of the burden of periodontal diseases in LAC and highlights the significant public health concern that it represents for the region.

Resumo em Inglês:

Abstract There is scarcity of information on the determinants of periodontitis in Latin America and Caribbean countries. We conducted a comprehensive review of studies examining the association of smoking and diabetes with periodontitis outcomes in this region. We searched for population-based, cross-sectional and prospective cohort studies from Latin America and the Caribbean region that reported on the association between smoking or diabetes and periodontitis. Databases were searched up to October 2023 by two reviewers. Subsequently, two authors independently conducted a rigorous data extraction process, focusing on study characteristics, the definition of exposures, and periodontitis outcomes, including measures of association and main findings. The results revealed a significant association between smoking and periodontitis, with a stronger effect observed in heavy smokers. Conversely, while some studies observed a higher prevalence of periodontitis among diabetic individuals, the association between diabetes and periodontitis was not significant after adjusting for confounding factors. These findings underscore a significant research gap in population-based studies on the effect of smoking and diabetes on periodontitis within Latin American and Caribbean countries, particularly when it comes to cohort studies. Addressing these gaps is crucial for a deeper understanding of these associations, which could lead to more effective prevention and treatment strategies in the region.

Resumo em Inglês:

Abstract This is a new version of the LAOHA Consensus on Periodontal Disease and its impact on general health in Latin America. Five years after the first version, knowledge has increased, and diagnosis of periodontal disease has evolved. Of especial interest relative to this topic has been the emergence of studies that have used the AAP/EFP Classification of Periodontal and Peri-Implant Diseases and Conditions since it is the core (?)of the art of diagnosis in preventive and therapeutic strategies. To make an accurate and effective diagnosis, knowledge about the health-disease process is fundamental. This article updates and demonstrates challenges in periodontal diagnosis, especially in Latin American countries. Considering that periodontal diagnosis should be based on knowledge of the etiopathogenesis of periodontal diseases, this article points out aspects developed in the last few years and emphasizes the knowledge that has been established, considering diagnosis of periodontal diseases. The evidence available stresses the importance of interviewing the patient, by implementing periodontal charting, and requesting any imaging and other complementary tests necessary. An important observation is that the partial periodontal data recordings used for screening (up to now) are not diagnostic methods and might underestimate disease. Moreover, in this article approaches to other forms of recognizing periodontal diseases are described, which could be used, however, not for the purpose of diagnosis, but for increasing awareness and eventually for referring individuals. In Latin American countries there is a need to increase the awareness of periodontal diseases among both the population and the profession, with particular emphasis on prioritizing correct periodontal diagnosis. In Dental education, strategies need to be established with the purpose of understanding that diagnosis is pivotal to any clinical approach.

Resumo em Inglês:

Abstract Periodontal diseases are closely related to non-communicable diseases, and their prevention depends on their link with healthy lifestyle programs. The purpose of this consensus was to summarize and propose preventive strategies at the community, individual, and research levels in Latin America and the Caribbean. A critical review and search strategy was carried out in Pubmed, LILACS, and SCIELO on three topics: a) Social determinants, risk factors, and behavioral changes related to PD throughout the lives of individuals; b) Impact of mechanical and chemical control of plaque for the prevention of gingivitis; c) Impact on prevention of systemic diseases. Relative to public health policies, no consensus was reported in the region. In some countries, periodontal educational strategies, mainly for pregnant women and for other chronic diseases have been implemented, but their impact on primary and secondary prevention has hardly been evaluated. In recent years, a positive aspect has been the implementation of some public policies, including clinical practice guidelines and care pathways. Based on the latest consensus, multicenter educational research and technological strategies were found in the region, but their effectiveness needs to be evaluated in clinical studies. A barrier to the implementation of preventive strategies has to do with the human factor. Therefore, the training of periodontists to be experts in communication strategies, technologies that allow the empowerment of patients for taking care of their periodontal health are required . Moreover, it is necessary to train professionals from other areas of health, who are more aware of the importance of oral health as a healthy lifestyle.

Resumo em Inglês:

Abstract The prevalence of periodontitis in Latin American and Caribbean countries (LACC) drew attention to a significant public health issue exacerbated by socio-economic disparities. This consensus report, based on the European Federation of Periodontology (EFP) S3 level clinical practice guidelines, proposed a multifaceted approach to periodontal health-care. The report highlighted the critical need for holistic, population-wide health policies and underscored the lack of documented community interventions in contemporary literature. The consensus advocated for a patient-centered approach to periodontal care, with non-surgical and surgical interventions, and a long-term commitment to supportive periodontal care (SPC). It emphasized the importance of patient engagement in biofilm control by means of home-care and professional interventions for long-term periodontal health. The report also stressed that subgingival instrumentation benefits even severely compromised teeth, by significantly reducing probing depths and gingival inflammation. Moreover, it emphasized the importance of personalized, long-term SPC for maintaining oral health post-treatment, and pointed out the need to identify factors influencing patient adherence. The aim of this report was to provide actionable guidance for clinicians and policymakers, focused on improving periodontal health outcomes and quality of life in LACC.

Resumo em Inglês:

Abstract The 2024 Consensus on Periodontology for Latin America and the Caribbean addresses the significant public health issue of periodontal diseases, impacting millions in the region. This comprehensive document presents holistic recommendations to standardize diagnostic methodologies, enhance public awareness, and integrate preventive and therapeutic practices into general healthcare. Key areas include understanding the prevalence and impact of periodontal diseases, identifying risk factors, and improving diagnostic, preventive, and treatment strategies. The consensus emphasizes interdisciplinary collaboration, tailored public health interventions, and the importance of continuous monitoring and research. By unifying efforts across various sectors, the consensus aims to reduce the burden of periodontal diseases, thereby improving both oral and general health outcomes in Latin America and the Caribbean.