Editorial: Periodontal Disease – A Public Health Problem

In 2010, the World Health Organization published an important report entitled " Equity, Social Determinants and Public Health Programmes " (1, 2) revealing that among priority public health conditions, oral health represents a global problem linked to inequalities in social circumstances (3). Periodontal disease, a chronic inflammatory disease resulting in progressive attachment and alveolar bone loss, is, after dental caries, one of the most important oral diseases contributing to the global burden of chronic disease (4), and it meets the criteria for consideration as a public health problem that requires action, as defined by Thomson et al. (5): i) it is widespread as affects " more than 50% of the adult population, while its severe forms affect 11% of adults, making severe periodontitis the sixth most prevalent disease of mankind " (6); ii) periodontitis severely impairs the individuals' oral health-related quality of life (7, 8), their self-esteem (9) and their general well-being (10). Furthermore, several research studies have associated periodontal disease with various systemic diseases and conditions, such as diabetes, HIV, atherosclerotic vascular disease, rheumatoid arthritis, adverse pregnancy outcomes, obesity, and metabolic syndrome (11–18); iii) the costs of treating the periodontal disease are substantial (19–22); and iv) due to the current state of knowledge of the risk factors implicated in the etiopathogenesis of periodontal disease [e.g., smoking (23, 24), alcohol (25–27), poor diet, lack of exercise (28–30), stress, distress, and psychological-coping resistance (31–34)], there is sufficient information to allow the effective control of the common forms of the disease. Several strategies of controlling periodontal disease have been described, such as the population strategy that requires use of the public health approach for changing health behaviors (e.g., smoking, oral self-care) (35), the secondary prevention strategy, and a high-risk strategy in persons at special risk (5). As non-communicable chronic diseases share numerous risk factors with periodontal diseases (18), The Common Risk Factor Approach (CRFA) and the health promotion approach have been acknowledged as key aspects of the strategies aimed at those who are known to be at high risk (36, 37). Within the dental profession globally, for years, the treatment, control, and prevention of peri-odontal disease has been under the dominance of the biomedical model emphasized on the molecular and biological basis of disease at the individual level and focused on a professional dependency representation with clinical surgical procedures and ongoing maintenance therapy (38). The preventive component in this patient-centered approach was …