The periodontal disease-systemic health-infectious disease axis in developing countries

Oral health is relatively low priority in the health policy of many developing countries. These countries, particularly those in sub-Saharan Africa, are still constrained by a wide range of infectious diseases such as HIV/AIDS, tuberculosis, measles and malaria, as well as by a heavy burden of intergenerational malnutrition. There is currently a disturbing trend in the rise of noncommunicable diseases in these countries. The noncommunicable diseases share many risk factors with periodontal diseases, the prevalence and severity of which are already markedly influenced by microbial infections. There are many fundamental gaps in our understanding of oral diseases, particularly in resource-poor settings. Perhaps this is the time to integrate neglected oral diseases and the noncommunicable diseases into the relatively well-funded global programs for the elimination of malaria, tuberculosis, AIDS and malnutrition.