Scielo RSS <![CDATA[Brazilian Oral Research]]> vol. 34 num. lang. en <![CDATA[SciELO Logo]]> <![CDATA[Periodontal disease and its impact in Latin America]]> <![CDATA[Periodontal disease and its impact on general health in Latin America. Section IV: Diagnosis]]> Abstract: The art of diagnosis is of great importance in the management of any disease. This includes preventive and therapeutic strategies. To make an accurate and effective diagnosis, knowledge about the health-disease process is fundamental. This paper reviews the important aspects for periodontal diagnosis in a contemporary approach, and endeavors to establish challenges for improving periodontal diagnosis, especially in Latin America. Considering that contemporary periodontal diagnosis should be based on knowledge of the etiopathogenesis of periodontal diseases, this paper highlights that the recently proposed classification system for periodontal diseases and conditions was based on the best available evidence. This system was conceived for individual diagnosis, therefore, its use in research and epidemiological settings might be limited. The system leads to a practical implication that stresses the importance of interviewing the patient, thorough periodontal charting, and requesting any imaging and other complementary tests necessary. An important observation is that partial periodontal data recordings usable for screening are not diagnostic methods and might underestimate disease. The goals of utmost importance for Latin America are to increase the awareness of both the population and the profession and to prioritize correct periodontal diagnosis. In addition, learning how to use the new classification system will help with diagnosing periodontal diseases. <![CDATA[Periodontal disease and its impact on general health in Latin America. Section II: Introduction part II]]> Abstract: The epidemiological data on gingivitis and periodontitis in Latin America are scarce, as the majority of the Latin American studies have analyzed probing depth instead of clinical attachment loss. Reported data have shown high variations in results between different Latin American countries, with the main causes of these differences being the clinical case definition and methodological strategies used. In general, data have revealed that the prevalence of periodontal disease is higher in Latin Americans than in populations in the USA or Europe. Regarding its relations with other diseases and conditions, some Latin American studies have focused on the association between periodontitis and adverse pregnancy outcomes, or poor glycemic control in diabetic patients; however, these studies have reported controversial results. In Chile, reports have indicated that periodontal treatment significantly reduced the preterm birth rate; however, no association between periodontitis and perinatal outcome was found in Brazil. For diabetes mellitus, Brazilian studies have reported controversial findings; however, a Chilean interventional study reported significant reductions in the glycosylated hemoglobin levels after periodontal treatment. Although epidemiological data for Latin America are scarce, the information available at present is useful for establishing national policies on health promotion, prevention, and treatment of periodontal disease. Therefore, dental schools must play a key role in educating professionals who are highly trained in the promotion, prevention, early diagnosis and treatment of periodontal disease, with an approach to risk, and strong biopsychosocial and ethical components. Thus, future Latin American dentists would be able to face the challenge of decreasing the prevalence of periodontal diseases by leading interdisciplinary health teamwork. <![CDATA[Periodontal disease and its impact on general health in Latin America. Section I: Introduction part I]]> Abstract: A high level of general and oral health are invaluable assets, a factor not always considered a basic human right for their better life quality. The mouth is a critical point of contact with the external environment, which is established when we talk, chew, swallow and when food digestion begins. From a perspective of the human condition, the mouth is crucial for the integration of sound, social appearance of the individual, and is one of the fundamental components of overall health. Therefore, not having an adequate level of oral health affects self-esteem, quality of life and people's general well-being. <![CDATA[Strategies for the prevention of periodontal disease and its impact on general health in Latin America. Section III: Prevention]]> Abstract: Dental plaque removal and the understanding of risk factors, risk indicators and social determinants are important components in the prevention of periodontal disease. Periodontal diseases and dental caries are largely preventable conditions, but require a “common risk factor approach” with non-communicable diseases with the purpose of improving their prevention and control, and positive impact on health. The aim of this consensus was to identify the evidence and gaps in periodontal prevention in Latin American, and to propose individual and collective recommendations for the population, health professionals, dental practice and government. The prevention of periodontal diseases in Latin America has mainly been focused on oral hygiene instruction, use of toothbrushes and interproximal devices, but in some patients, it is necessary to use adjuncts to these measures, such as antimicrobial and/or probiotic products that are backed by broad scientific evidence. Some evidence has shown that there are inadequate knowledge, attitudes and practices among patients, dentist and other health professionals. The prevention of periodontal diseases and caries should be adopted as a healthy lifestyle routine, because of their local and systemic effects. Recently, new empowerment strategies have been proposed in order to generate behavioral changes. Periodontal diseases can often be prevented, or controlled by joined efforts between government health systems, scientific associations, universities, health professionals, private companies and communities. In conclusion, the relations between periodontal diseases, caries, healthy lifestyles and NCD's offer an ideal opportunity to change Latin American prevention strategies at both the individual level and population levels. <![CDATA[Periodontal disease and its impact on general health in Latin America. Section V: Treatment of periodontitis]]> Abstract: Gingivitis and periodontitis are associated with a negative impact on Oral Health Related Quality of Life (OHRQoL), exerting a significant influence on aspects related to the patients' function and esthetics. Periodontitis has been associated with several systemic conditions, including adverse pregnancy outcomes, cardiovascular diseases, type 2 diabetes mellitus (DM), respiratory disorders, fatal pneumonia in hemodialysis patients, chronic renal disease and metabolic syndrome. The aim of this paper was to review the results of different periodontal treatments and their impacts on patients' OHRQoL and systemic health. Non-surgical and surgical periodontal treatments are predictable procedures in terms of controlling infection, reducing probing pocket depth and gaining clinical attachment. In addition, the treatment of periodontitis may significantly improve OHRQoL and promote a reduction in the levels of systemic markers of inflammation, including some cytokines associated with cardiovascular diseases. Studies have also suggested that periodontal treatment may improve glycemic control in patients with DM. Strategies and actions for preventing the onset and recurrence of periodontitis, and the challenges facing the field of periodontology in the XXI century are presented in this review. <![CDATA[Periodontal disease and its impact on general health in Latin America: LAOHA Consensus Meeting Report]]> Abstract: Periodontal diseases are considered a worldwide public health problem, owing to their high prevalence in developed and developing countries. Periodontitis may lead to tooth loss, which can impact oral health-related quality of life. Gingivitis and periodontitis have been extensively studied regarding their etiopathogenesis, epidemiology, prevention and treatment outcomes. However, most of these aspects are studied and discussed globally, which may hamper a clear interpretation of the findings and the design of effective plans of action for specific regions or populations. For example, in Latin America, epidemiological data about the distribution of periodontal diseases is still scarce, mainly when it comes to nationwide representative samples. This Consensus aimed to address the following topics related to periodontal diseases in Latin America: a) The impact of the global burden of periodontal diseases on health: a global reality; b) Periodontal diseases in Latin America; c) Strategies for the prevention of periodontal diseases in Latin America; d) Problems associated with diagnosis of periodontal conditions and possible solutions for Latin America; e) Treatment of Periodontitis. This consensus will help to increase awareness about diagnosis, prevention and treatment of periodontal diseases, in the context of Latin American countries.