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science & practice 23Show Preview IDS Cologne 2015 Inareport,researchersoftheGlobal Burden of Diseases, Injuries, and Risk FactorsStudyhaverecentlyshedlight on the global dimensions of severe pe- riodontitis, which now affects over 700 million people worldwide. This study is a major effort involving more than1,000scientiststosystematically produce comparable estimates of the burden of 291 diseases and injuries and their associated 1,160 sequelae in 1990, 1995, 2005 and 2010. Dental Tribune UK had the opportunity to speak with lead author Prof. Wagner Marcenes from Barts and The London School of Medicine and Dentistry in London about the findings and why they are a cause for concern. Dental Tribune: Prof. Marcenes, theprevalenceofsevereperiodonti- tis on a global scale has not in- creased significantly in the last two decades, according to your report. Whyarethenumbersworryingnev- ertheless? Prof. Wagner Marcenes: Hav- ing more than 700 million people suf- fering from severe periodontitis is re- ally worrying. Although the propor- tion remained the same in 1990 and 2010, the number of people needing periodontal treatment has increased dramatically. This is because world- wide more than one in ten people suf- fer from severe periodontitis and the world population grew from 5.3 bil- lion in 1990 to 6.9 billion in 2010. Moreover, severe periodontitis tends todevelopduringadulthood,showing a steep increase between the third and fourth decades of life. With more people living longer and retaining their teeth for life, the risk of develop- ing severe oral health-related prob- lems, particularly periodontitis, will be high. The world’s population is ex- pected to almost double by end of this century, implying that the number of people with severe periodontitis may at least double. How do the results compare to the situation prior to the surveyed period? We have updated the data from the first Global Burden of Disease (GBD) study and generated compara- ble figures in 1990 and 2010. There- fore, we were able to compare the cur- rent and the previous situation to our survey in 2010. Since the study is unique, we do not have global data before the first GBD study. However, we know that oral diseases have de- creased significantly in most industri- alised countries, such as the UK and the US, in the last five decades. Severe periodontitis appears to bemostprevalentinSouthAmerica and east sub-Saharan Africa. What could be the reasons for that? Our study was not actually de- signed to test risk factors of periodon- tal disease, but based on pure reason- ing, I would say that, in addition to de- mographic changes, smoking and poor oral hygiene may be the main factorsassociatedwithit.Thisisspec- ulation, but what we see at the moment is a growing number of peo- ple smoking in developing regions contrary to the trend in most devel- oped countries. Nearly 80per cent of the more than one billion smokers worldwide live in low- and middle- income countries. With 1,500 new caseseveryyear,Argentinaforexam- ple has the highest incidence of se- vere periodontitis, which is almost double the global average, and high tobacco consumption. We cannot es- tablish a cause and effect relation- ship, but I believe that the high inci- dence of periodontitis in these areas is most likely related to the habit of smoking. In you report, you mention how difficult it is to determine disease prevalenceowingtodifferentclassi- ficationsystems.Isyourrepresenta- tionofthesituationthereforeareal- istic one? I am confident our report pro- vides a realistic, comprehensive as- sessment of the global burden of se- vereperiodontitis.Aftermuchconsid- eration, we used a Community Peri- odontal Index of Treatment Needs scoreof4,aclinicalattachmentlossof greater than 6millimetres or a pocket depthofmorethan5millimetresasin- dicators of periodontitis. We used the measurements adopted by the World Health Organization, which are con- sidered by most as the most reliable indicators of severe periodontitis. We endeavoured to reflect the measures adopted by the larger community of public health dentistry. Thechoiceofincludingonlysevere periodontitis and not less severe forms of periodontal disease, such as mild or moderate periodontitis and gingivitis, was because of their low impact (dis- ability weight) on quality of life. Since periodontitis tends to progress from mild to severe if untreated, our num- bers reflect only the tip of the iceberg, indicating the seriousness of the chal- lenge to health professionals. Why is the situation so little ad- dressed by the dental community, Innovation in Application Sulzer Mixpac Ltd Ruetistrasse 7 CH 9469 Haag, Switzerland P +41 81 772 20 00 F +41 81 772 20 01 mixpac@sulzer.com www.sulzer.com Besuchen Sie uns: Halle 3.2 Stand B-041 10. bis 14. März The new dispenser generation Noticeable quality enhancements. Elegant design, improved application properties, optimized ergonomics and simplified handling enable maximum precision and fatigue-proof daily use in your practice! The new dispenser is fully compatible with the MIXPAC™ multi component system for 18 ml to 75 ml cartridges. For additional information please visit us at the IDS or contact your dental specialist. MIXPAC™ S-Dispenser II Precise and ergonomic performance in style Visit us: Hall 3.2 Booth B-041 10th to14th of March AD Prof. Wagner Marcenes “With more people living longer and retaining their teeth for life,the risk of developing severe oral health-related problems,particularly periodontitis,will be high.” ª “It is unacceptable to neglect severe oral diseases” An interview with Barts andThe London School of Medicine and Dentistry ProfessorWagner Marcenes,London. P +41817722000 F +41817722001