Trends in the global, regional, and national burden of oral conditions from 1990 to 2021: a systematic analysis for the Global Burden of Disease Study 2021.
Level 3 - non-randomized controlled study
Systematic Bayesian meta-regression modeling of global observational surveys, registries, and vital statistics (GBD 2021)
PubMed 40024264 · doi:10.1016/S0140-6736(24)02811-3
What was done
The study utilized data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 to estimate the global, regional, and national prevalence and disability-adjusted life-years (DALYs) for oral conditions between 1990 and 2021. Conditions analyzed were untreated dental caries (deciduous and permanent teeth), severe periodontitis, edentulism, other oral disorders, lip and oral cavity cancer, and orofacial clefts. Input data from epidemiological surveys, registries, and vital statistics were integrated using DisMod-MR 2.1, a Bayesian meta-regression tool, to generate metrics with 95% uncertainty intervals (UIs). DALYs combined years lived with disability (YLDs) and years of life lost (YLLs).
What was found
In 2021, the combined global age-standardised prevalence of main oral conditions was 45,900 (95% UI 42,300 to 49,800) per 100,000 population, totaling 3.69 billion (3.40 to 4.00) affected individuals. Untreated permanent dental caries (27,500 per 100,000) and severe periodontitis (12,500 per 100,000) were the most prevalent. Edentulism, severe periodontitis, and lip and oral cavity cancer caused the largest DALY burdens. Over 1990–2021, total case counts and DALYs rose for most conditions, except deciduous caries (no change) and orofacial clefts (-68.3% [95% UI -79.3 to -46.5] DALY decrease). Age-standardised prevalence and DALY rates declined for permanent caries and edentulism, stayed flat for deciduous caries and severe periodontitis, and increased in prevalence for lip/oral cancer. Regionally, the African and Eastern Mediterranean regions had the largest increases in cases and DALYs, while Europe was the only region with decreasing age-standardised caries prevalence in both deciduous (-9.88%) and permanent (-5.94%) teeth.
Why it matters
Oral conditions remain among the most widespread non-communicable diseases globally, and the lack of substantial decline in age-standardised burden over 30 years shows that existing health strategies are failing to meet WHO reduction goals.
Limits
Findings rely on statistical modeling across heterogeneous international surveys, registries, and vital statistics that vary widely in regional data availability and completeness. The abstract does not disclose the precise number of underlying studies or individual participant counts, and the observational GBD framework cannot establish causal mechanisms for regional disparities.