Synopsis

Part I serves as an introduction to the book as a whole. Because patterns of health and disease exhibit wide variations throughout the world, a background of geography and demography is essential. Various features of the tropical environment are considered, together with general disease trends in these regions. A chapter on the science of epidemiology has been included to discuss the basis of methods appropriate to the collection and analysis of oral health data, in the hope of encouraging more and better analytical epidemiological studies of oral health and disease in the tropics.  <br/>Part II deals mainly with anthropological, anthropomorphic, and cultural aspects of oral diseases in the tropics. It is rather surprising that previous textbooks of oral pathology and oral medicine have not provided information of this kind. The chapter on ‘Endemic Dental Fluorosis’ should be useful to the tropical readership as there is currently a serious worldwide debate on the propriety of, and approach to, fluoridation of water and the use of fluoridated toothpastes in endemic areas. An interesting and important feature of this part of the book is the chapter on cultural aspects of populations and their possible effects on oral health. Many of the cultural and traditional practices involving the teeth in tropical populations are regarded as ‘esthetic’ by the indigenous peoples; the relevant chapter should prove fascinating for both tropical and nontropical readerships.  <br/>Part III deals with a neglected area of oral pathology and oral medicine. Infectious diseases which present a major public health threat to the region are dealt with first, followed by tropical nutritional diseases, anemias, hemoglobinopathies, bleeding disorders and endocrinopathies. It has been our experience in the tropics that dental curricula (and the books prescribed for dental undergraduate programs on subjects such as pathology, microbiology, and general medicine) have not emphasized adequately those infections, and nutritional diseases which have such direct relevance to the day-to-day clinical practice of dentistry. Some of the diseases discussed do not necessarily have oral manifestations but are important to general health and to the impact of oral disease and dental treatment on affected individuals. Many do, however, have oral manifestations and these may be the first sign of serious systemic disease. Notable among these are viral infections, particularly acquired immune deficiency syndrome (AIDS). The latter is a rapidly and tragically changing phenomenon in the tropical world: we have included the most recent information available at the time of going to press.  <br/>Part IV deals with neoplastic disease, ranging from odontogenic tumors to leukemias. Because of the heavy regional disease burden, oral squamous cell carcinomas and oral mucosal premalignant lesions have received considerable attention. An Indian bias in these chapters is deliberate because of the wealth of data available from this region, where nearly half of all cancer patients are victims of oral squamous cell carcinomas. Malignancies such as Burkitt’s lymphoma, though no longer confined to Africa alone, still pose a serious threat to life for African children. Dental practitioners in this region have a special role to play in its diagnosis and in the management of complications.  <br/>Modern views on carcinogenesis and on the immunological aspects of oral cancer are included, and will perhaps be useful to research workers in the tropics. A chapter providing a working knowledge of the management of oral cancer is also an important inclusion in this part of the book.  <br/>Part V essentially deals with oral disease of universal occurrence—the so-called ‘cosmopolitan’ oral conditions. Where appropriate, their peculiar distribution or behavioral pattern in the tropical context has been emphasized. Diseases such as dental caries, inflammatory periodontal diseases, and maxillofacial trauma have received greater attention because of their high morbidity in the region. A chapter on craniofacial anomalies was structured differently from other chapters because the majority of the syndromes listed are rare. The inclusion of a chapter on forensic aspects of dentistry should fill a major gap in dental literature; we regard this as an important component of the undergraduate dental curriculum throughout the world.