Nutrition and oral health in Africa.

Poverty, low birth weight, low life expectation at birth, widespread malnutrition, numerous endemic infections, little or no access to safe water, poor oral hygiene, deplorable environmental sanitation and political instability among other problems, characterise the lives of many Africans, particularly in sub-Saharan Africa. In African countries undergoing rapid urbanisation, health problems associated with undernutrition and overnutrition coexist, and these result from lifestyle changes which promote physical inactivity, increased consumption of fats and refined carbohydrates, as well as abuse of tobacco and alcohol. Thus, in several African countries, inflammatory oral diseases (e.g. periodontal diseases, acute necrotising gingivitis, noma) resulting from inappropriate interactions between microorganisms and the malnourished, immunocompromised host, have continued to pose serious health problems. There are suggestions of increasing incidence of squamous cell carcinoma, probably related to increased use of alcohol and tobacco, which elicit nutrient deficiencies and oxidative stress. Additionally, there is an increase in caries prevalence particularly in the poor urban areas. The latter is related not only to increased availability of refined sugars, but also to limited access to the caries preventive effects of fluorides. Good dietary practices through judicious combination of available foods should therefore feature prominently in the promotion of optimal oral health in Africa.