EDITORIAL

Orbits of interest

WG Evans

SADJ Managing editor, E-mail: bill.evans@wits.ac.za

Astronomers have a word for it... the point at which orbiting bodies are closest to each other is termed the periapsis.... And if one of the orbiting bodies is the earth, that closest approach is called the perigee. In October we experienced a periapsis of two crucial bodies of movement... our own orbit of Oral Health month in September and the orbit of Breast Cancer month in October. We would do well to observe both with commitment and enthusiasm. Superimposed at this time has been the all-pervading devotion to the Rugby World Cup.... and many rugby players wore the pink band of Breast Cancer Awareness.

The most prevalent cancer amongst women, breast cancer accounts for some 20% of all female cancers. In 2010, there were 6125 new cases diagnosed. Males are also prone but at lower levels, with 135 new cases in 2010 and comprising only 0.5% of cancers. (By contrast, neoplasms in the mouth amongst males contributed 394 new cases at an incidence of 1.45% and tongue lesions recorded 322 new cases, at 1.19%. In females the figures are lower, mouth at 197 and 0.66% and tongue at 117 and 0.39%.)

Dental disease remains a scourge. We need look no further than the paper included in this issue in which dental caries status in six-year-old children is reported by Drs Reddy and Singh after their study conducted at Health Promoting Schools in KwaZulu-Natal, South Africa. The caries rate for their sample was 73% and 94% of the children required some form of treatment. In all assessments, the statistics revealed a deteriorating situation compared with data gathered in previous surveys in 1988 and in 2000. Tellingly, the sample indicated that we are far from achieving the goal set by the Department of Health that 60% of six year olds should be caries free.

By contrast the statistics for breast cancer do offer some small encouragement for with improved diagnosis and the recognition of preventive measures the survival rate can be as high as 93%. Cancer Association of South Africa

As the two orbits approach each other there are obvious similarities... in both instances Prevention and Early Diagnosis are paramount. Several controllable factors have been implicated in the aetiology of breast cancer, although the relationships may not be direct. Intriguingly, diet is one of those factors identified as important in preventing the condition. High intake of fat, a diet high in animal protein, alcohol in excess of two units a day have all been mentioned as contributing to the risk. The National Breast Cancer Foundation recommends that the risk can be reduced by:

• Maintaining a healthy weight

• Staying physically active

• Eating fruits and vegetable

• Regular self examination and mammograms

• Not smoking

• Limiting alcohol consumption

Dental disease may be prevented by the time tested and well known measures of personal care, chemotherapeutic intervention and control of diet:

• Meticulous oral hygiene

• Reduction or elimination of intake of refined sugar

• Fluoride, either as topical application or incorporated into water supply

• Regular dental inspections and treatment.

• Antibiotics offer a direct control over oral bacteria.

These preventive interventions are parallel, not identical. In every instance it is control of personal habits that is the key.

The orbits of the two conditions certainly approach closely and that very periapsis emphatically recognises the wide responsibilities of all health professionals in their roles as advisors, educators, monitors and deliverers of treatment. Perhaps we are closer to the role of the earth as the body having more obligations to meet and the correct term for that close approximation of orbits would be perigee. How did we do in September, Oral Health Month.. and how do we compare with Breast Cancer month in October?