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Rycina z artykułu: Ekspozom jamy ustnej:...
 
SŁOWA KLUCZOWE
DZIEDZINY
STRESZCZENIE
Wprowadzenie i cel:
Choroby jamy ustnej pozostają istotnym globalnym wyzwaniem zdrowotnym, dotykając około 3,5 mld ludzi. Gdy tradycyjne modele etiologiczne skupiały się głównie na czynnikach behawioralnych i mikrobiologicznych, nieproporcjonalne obciążenie chorobami w regionach uprzemysławiających się sugeruje obecność przeoczonych determinantów niebehawioralnych. Niniejszy przegląd ma na celu syntezę obecnej literatury na temat ekspozomu jamy ustnej, a także przedstawienie analizy, w jaki sposób determinanty środowiskowe (zanieczyszczenia atmosferyczne, metale ciężkie i zanieczyszczenia chemiczne) wpływają na zdrowie jamy ustnej w ciągu życia.

Opis stanu wiedzy:
Badania sugerują, że toksyny środowiskowe działają jak stresory, zaburzając homeostazę jamy ustnej. W próchnicy narażenie na bierne palenie (SHS) osłabia odporność, a metale ciężkie (np. ołów) wywołują hipoplazję szkliwa poprzez substytucję jonową. Drobny pył i kadm wpływają na przyzębie, wyzwalając stres oksydacyjny i zapalenie, co przyspiesza resorpcję kości. Ponadto narażenie kobiety w ciąży na zanieczyszczenie powietrza atmosferycznego i zagrożenia zawodowe działa jako krytyczny teratogen powodujący rozszczepy ustno-twarzowe płodu. Badania wiążą też zanieczyszczenia gazowe i formaldehyd z rakiem nosogardła.

Podsumowanie:
Dowody wskazują na konieczność włączenia oceny ryzyka środowiskowego do profilaktyki stomatologicznej. Zanieczyszczenia są mimowolnymi czynnikami ryzyka działającymi synergistycznie z innymi determinantami. W celu zmniejszenia obciążenia chorobami i kształtowania polityki zdrowotnej niezbędne są strategie łagodzące skutki tych zjawisk.

Introduction:
Oral diseases remain a major global health challenge, affecting app. 3.5 billion people. While traditional etiological models have focused primarily on behavioural and microbial factors, the disproportionate disease burden in industrializing regions suggests the presence of overlooked non-behavioural determinants.

Objective:
The aim of the review is to synthesize current literature regarding the ‘oral exposome’ analyzing how environmental determinants-specifically atmospheric pollutants, heavy metals and chemical contaminants impact oral health throughout the lifespan.

Brief description of the state of knowledge:
Recent research suggests that environmental toxicants may act as systemic stressors, potentially compromising oral homeostasis through a variety of mechanisms. Regarding dental caries, exposure to second-hand smoke (SHS) suppresses local immune responses, while heavy metals, such as lead, induce enamel hypoplasia via ionic substitution in the hydroxyapatite lattice. Periodontal health is similarly modulated by environmental factors, fine particulate matter and cadmium exposure trigger systemic oxidative stress and inflammation, accelerating alveolar bone resorption. Furthermore, maternal exposure to ambient air pollution and occupational hazards acts as a critical teratogen for orofacial clefts, particularly when interacting with genetic variants in folate metabolism. Finally, longitudinal data implicate gaseous pollutants and formaldehyde in the pathogenesis of nasopharyngeal carcinoma.

Summary:
Evidence necessitates integrating environmental risk assessment into preventive dentistry. Pollutants are involuntary risk factors acting synergistically with other determinants. Mitigation strategies are urgent for reducing the disease burden and informing policy.
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