Oral pathology in developing countries: the reality of Guinea-Bissau — an integrative review

Abstract

Introduction: Oral pathology remains a significant public health challenge in developing countries, particularly in contexts of socio-economic vulnerability and limited access to healthcare.

Objectives: To analyze the available evidence on oral pathology in Guinea-Bissau, identifying prevalent conditions, associated risk factors, and public health implications.

Methodology: An integrative literature review was conducted using PubMed, Embase, SciELO, BVS, ScienceDirect, Cochrane Library, and Google Scholar, including studies published in Portuguese, English, French, and Spanish up to April 2025. Studies involving human populations from Guinea-Bissau were prioritized. Due to the limited availability of country-specific data, studies from similar socio-economic contexts were also considered.

Results: The findings indicate a high prevalence of preventable oral diseases, particularly dental caries and periodontal disease, along with frequent reports of odontogenic infections and oral manifestations associated with Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome. Less commonly reported conditions include oral cancer, cysts, and odontogenic tumors. Noma emerged as the most severe condition, strongly associated with extreme poverty, malnutrition, poor oral hygiene, and immunosuppression. Important gaps were identified, including limited epidemiological data, heterogeneity of available studies, absence of surveillance systems, and restricted access to healthcare.

Conclusion: The evidence highlights the urgent need to strengthen public health strategies, including preventive interventions, workforce training, healthcare infrastructure development, and community-based education. The recognition of noma as a Neglected Tropical Disease by the World Health Organization in 2023 represents a critical opportunity to promote research, mobilize resources, and implement policies aimed at reducing health inequalities in Guinea-Bissau.