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prevention International magazine for oral health No. 1, 2017

opinion | a need for prevention Søren Jepsen: Even in advanced countries, many people have difficulty accessing oral care services The prevalence of periodontitis is strongly associated with socio-economic status, according to Prof. Søren Jepsen, past President of the European Federation of Periodontology and co-author of its Perio Focus paper. It is up to the oral health care community to help make reliable professional oral health care services truly accessible to the entire population. AUTHOR: DENTAL TRIBUNE INTERNATIONAL / PROF. SØREN JEPSEN Gates Foundation, looked at all human diseases and their impact on health and well-being. The results indicate that se- vere periodontitis is one of the major contributors to the burden of human disease in several ways: i) directly, through the sequelae of per- iodontitis itself; ii) indirectly, through the contribu- tion of severe periodontitis to eden- tulism and loss of masticatory func- tion; and iii) through co-morbidity with a host of systemic diseases, such as dia- betes, atherosclerosis, obesity and arthritis. The global cost of lost productiv- ity from severe periodontitis alone has been estimated to be US$54 billion per year, while the total economic im- pact of periodontal disease accounts for a major component of the US$442 billion that constituted the direct and indirect cost of oral disease incurred in 2010. Clearly, the costs to society are great. It has been calculated that peri- odontitis is responsible for lost pro- ductivity for a dollar amount similar to a small European country — and then there are the treatment costs! Severe periodontitis is responsible for a sig- nificant amount of the financial costs of oral health: in many developed countries, it is about 0.5–0.8 per cent of gross domestic product. What is par- ticularly worrisome is that the social burden is borne disproportionately by the more vulnerable segments of the population. For many citizens, even in developed nations, severe periodontitis may be a handicap and a form of social exclusion. What kinds of cultural and socio-eco- nomic barriers to professional care prevent equal access to the necessary treatment? There are many barriers, and if we look around the world, we may feel lost in a myriad of cultural and socio- economic barriers. These clearly differ in developed and developing nations. In developed countries, the availability of information on the Internet is prob- ably the greatest barrier to access to Prof. Søren Jepsen What are some of the socio-economic costs and implications of periodontal disease? We have to realise that periodontal disease is probably the most com- mon disease of all. Because of global population growth, ageing societies and increased tooth retention, the number of people affected by periodontitis has grown substantially. The total burden of disease increased globally by about 67 per cent between 1990 and 2013. A recent Global Burden of Disease study, supported by the Bill & Melinda 10 issue #1

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