Oral Health, U.S. 2002 Annual Report
Section 15: LINKS TO SYSTEMIC HEALTH/ MANIFESTATIONS OF SYSTEMIC DISEASE
During the past decade there has been increasing evidence documenting the relationships between oral health and systemic disease. Systemic conditions that have been reported to be associated with oral health include diabetes, HIV/AIDS, osteoporosis, respiratory and vascular diseases, osteoarthritis and rheumatoid arthritis, oral cancers, and preterm low-birth weight pregnancy outcomes. HIV/AIDS, diabetes, and osteoporosis have been reported to be risk factors for periodontal disease (US DHHS, 2000; Chen, 2000). Periodontal disease has also been suggested to have an effect on the control of diabetes. There are a number of oral manifestations associated with these diseases. Oral manifestations of HIV infection include oral candidiasis (most common), hairy leukoplakia, Kaposi's sarcoma, oral erythema, labial herpetic infection, herpes simplex virus, varicella-zoster virus, cytomegalovirus, aphthous ulceration, gangrenous stomatitis, xerostomia, and periodontal disease (Gillespie & Marino, 1993; Scully & McCarthy, 1992; Itin et al., 1993; McKaig et al., 2000). Oral soft tissue abnormalities associated with diabetes include hyperplastic gingivitis (Van Dis et al., 1988) and lichen planus (Bagan-Sebastian, 1992).
Joint diseases also can have oral manifestations. Osteoarthritis and rheumatoid arthritis may affect the temporomandibular joints (TMD, temporomandibular joint disorder), leading to chronic deterioration of the joint. Patients may present with pain and diminished function (Chen, 2000). Some cases of TMD can be attributed to these types of arthritis. Respiratory diseases that may be affected by poor oral health include bacterial pneumonia and chronic obstructive pulmonary disease (Taylor et al., 2000; Chen, 2000).
Medications and treatments associated with a variety of systemic diseases have consequences for oral health. Mucositis caused by cancer therapies can often be a limiting factor in therapy. Xerostomia is associated with a large number of medications.
This section examines the prevalence of type 1 and type 2 diabetes, dental visits in the past year by diabetics, the prevalence of oral manifestations of HIV/AIDS, and the prevalence of osteoporosis.
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