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
Issued Date
2025-03-15
Resource Type
ISSN
01406736
eISSN
1474547X
Scopus ID
2-s2.0-105000060156
Pubmed ID
40024264
Journal Title
Lancet
Volume
405
Issue
10482
Start Page
897
End Page
910
Rights Holder(s)
SCOPUS
Bibliographic Citation
Lancet Vol.405 No.10482 (2025) , 897-910
Suggested Citation
Bernabe E., Marcenes W., Abdulkader R.S., Abreu L.G., Afzal S., Alhalaiqa F.N., Al-Maweri S., Alsharif U., Anyasodor A.E., Arora A., Asgary S., Ashraf T., Balasubramanian M., Banakar M., Barrow A., Bashiri A., Belay S.A., Belgaumi U.I., Berhie A.Y., Bhardwaj P., Bhaskar S., Bijani A., Bouaoud S., Cao Y., Chaurasia A., Chen M.X., Chu D.T., Cruz-Martins N., Dadras O., Dai X., Diaz D., Du M., Ekholuenetale M., Ekundayo T.C., Tantawi M.E., Elhadi M., Fagbamigbe A.F., Farshidfar N., Fatehizadeh A., Fischer F., Folayan M.O., Gaewkhiew P., Gajdács M., Golechha M., Gupta B., Gupta S., Hagins H., Halboub E.S., Hamidi S., Hariyani N., Hay S.I., Heidari M., Herrera-Serna B.Y., Heyi D.Z., Hostiuc S., Humphrey K.M., Ibitoye S.E., Ilic M.D., Isola G., Kandaswamy E., Kantar R.S., Kaur N., Kemmer L., Khader Y.S., Khateri S., Kisa A., Krishan K., Kruger E., Lalloo R., An L., Lim S.S., Mestrovic T., Mokdad A.H., Moreira R.S., Morrison S.D., Murray C.J.L., Natto Z.S., Nayak B.P., Nguyen T., Nguyen V.T., Omotayo A.O., Padron-Monedero A., Patel J., Patil S., Pawar S., Petcu I.R., Qattea I., Rahman M., Ratan Z.A., Riad A., Manjula S., Chandan S.N., Sabour S., Sharif-Askari F.S., Sahebkar A., Sakshaug J.W., Samy A.M., Sarode S.C., Sawhney M., Schwendicke F. 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. Lancet Vol.405 No.10482 (2025) , 897-910. 910. doi:10.1016/S0140-6736(24)02811-3 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/116771
Title
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
Author(s)
Bernabe E.
Marcenes W.
Abdulkader R.S.
Abreu L.G.
Afzal S.
Alhalaiqa F.N.
Al-Maweri S.
Alsharif U.
Anyasodor A.E.
Arora A.
Asgary S.
Ashraf T.
Balasubramanian M.
Banakar M.
Barrow A.
Bashiri A.
Belay S.A.
Belgaumi U.I.
Berhie A.Y.
Bhardwaj P.
Bhaskar S.
Bijani A.
Bouaoud S.
Cao Y.
Chaurasia A.
Chen M.X.
Chu D.T.
Cruz-Martins N.
Dadras O.
Dai X.
Diaz D.
Du M.
Ekholuenetale M.
Ekundayo T.C.
Tantawi M.E.
Elhadi M.
Fagbamigbe A.F.
Farshidfar N.
Fatehizadeh A.
Fischer F.
Folayan M.O.
Gaewkhiew P.
Gajdács M.
Golechha M.
Gupta B.
Gupta S.
Hagins H.
Halboub E.S.
Hamidi S.
Hariyani N.
Hay S.I.
Heidari M.
Herrera-Serna B.Y.
Heyi D.Z.
Hostiuc S.
Humphrey K.M.
Ibitoye S.E.
Ilic M.D.
Isola G.
Kandaswamy E.
Kantar R.S.
Kaur N.
Kemmer L.
Khader Y.S.
Khateri S.
Kisa A.
Krishan K.
Kruger E.
Lalloo R.
An L.
Lim S.S.
Mestrovic T.
Mokdad A.H.
Moreira R.S.
Morrison S.D.
Murray C.J.L.
Natto Z.S.
Nayak B.P.
Nguyen T.
Nguyen V.T.
Omotayo A.O.
Padron-Monedero A.
Patel J.
Patil S.
Pawar S.
Petcu I.R.
Qattea I.
Rahman M.
Ratan Z.A.
Riad A.
Manjula S.
Chandan S.N.
Sabour S.
Sharif-Askari F.S.
Sahebkar A.
Sakshaug J.W.
Samy A.M.
Sarode S.C.
Sawhney M.
Schwendicke F.
Marcenes W.
Abdulkader R.S.
Abreu L.G.
Afzal S.
Alhalaiqa F.N.
Al-Maweri S.
Alsharif U.
Anyasodor A.E.
Arora A.
Asgary S.
Ashraf T.
Balasubramanian M.
Banakar M.
Barrow A.
Bashiri A.
Belay S.A.
Belgaumi U.I.
Berhie A.Y.
Bhardwaj P.
Bhaskar S.
Bijani A.
Bouaoud S.
Cao Y.
Chaurasia A.
Chen M.X.
Chu D.T.
Cruz-Martins N.
Dadras O.
Dai X.
Diaz D.
Du M.
Ekholuenetale M.
Ekundayo T.C.
Tantawi M.E.
Elhadi M.
Fagbamigbe A.F.
Farshidfar N.
Fatehizadeh A.
Fischer F.
Folayan M.O.
Gaewkhiew P.
Gajdács M.
Golechha M.
Gupta B.
Gupta S.
Hagins H.
Halboub E.S.
Hamidi S.
Hariyani N.
Hay S.I.
Heidari M.
Herrera-Serna B.Y.
Heyi D.Z.
Hostiuc S.
Humphrey K.M.
Ibitoye S.E.
Ilic M.D.
Isola G.
Kandaswamy E.
Kantar R.S.
Kaur N.
Kemmer L.
Khader Y.S.
Khateri S.
Kisa A.
Krishan K.
Kruger E.
Lalloo R.
An L.
Lim S.S.
Mestrovic T.
Mokdad A.H.
Moreira R.S.
Morrison S.D.
Murray C.J.L.
Natto Z.S.
Nayak B.P.
Nguyen T.
Nguyen V.T.
Omotayo A.O.
Padron-Monedero A.
Patel J.
Patil S.
Pawar S.
Petcu I.R.
Qattea I.
Rahman M.
Ratan Z.A.
Riad A.
Manjula S.
Chandan S.N.
Sabour S.
Sharif-Askari F.S.
Sahebkar A.
Sakshaug J.W.
Samy A.M.
Sarode S.C.
Sawhney M.
Schwendicke F.
Author's Affiliation
The University of Sydney
The University of Queensland
King's College London
Harvard University
The University of Edinburgh
Shandong University
Yale School of Medicine
Rijksuniversiteit Groningen
Washington University School of Medicine in St. Louis
Charité – Universitätsmedizin Berlin
Universidad Nacional Autónoma de México
The University of Western Australia
University of Washington School of Medicine
Case Western Reserve University
University of Bern
Universidade Federal de Minas Gerais
Tehran University of Medical Sciences
King Abdulaziz University
Universitetet i Bergen
Klinikum der Universität München
Università degli Studi di Catania
Mahidol University
University of Wollongong
University of Florida College of Medicine
Ain Shams University
Shahid Beheshti University of Medical Sciences
Masaryk University
NYU Langone Health
Flinders University
Western Sydney University
Saveetha Institute of Medical and Technical Sciences
Fundacao Oswaldo Cruz
Universidade Federal de Pernambuco
Barts and The London School of Medicine and Dentistry
Amity University
Faculty of Medicine and Health
Szegedi Tudományegyetem (SZTE)
The University of North Carolina at Charlotte
North-West University
Shiraz University of Medical Sciences
Panjab University
University of Ibadan
University of Portsmouth
Mashhad University of Medical Sciences
Universitas Airlangga
Edith Cowan University
Coventry University
Universitatea de Medicina si Farmacie Carol Davila din Bucuresti
University of Sharjah
Jordan University of Science and Technology
Universität Witten/Herdecke
National Cerebral and Cardiovascular Center
Obafemi Awolowo University
Jazan University
Vietnam National University, Hanoi
Charles Sturt University
Faculty of Medicine, Ain Shams University
Indian Council of Medical Research
LSU Health Sciences Center - New Orleans
University of Lahore
Duy Tan University
King George's Medical University
Bucharest University of Economic Studies
Bahir Dar University
Université Ferhat Abbas Sétif 1
UW Medical Center – Montlake
University of Rajshahi
Tulane University School of Public Health and Tropical Medicine
Dr. D. Y. Patil Vidyapeeth, Pune
Babol University of Medical Sciences
i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Portugal
JSS Academy of Higher Education & Research
University of Michigan School of Dentistry
Khulna University of Engineering and Technology
All India Institute of Medical Sciences, Jodhpur
Shahrekord University of Medical Sciences
Iranian Ministry of Health and Medical Education
Kurdistan University of Medical Sciences
University of Medicine and Pharmacy at HCMC
Faculty of Medical Sciences, University of Kragujevac
Oxford University Clinical Research Unit
Institute for Health Metrics and Evaluation
Adelaide Dental School
Faculty of Medicine and Health
Klinikum Dortmund
Cooperativa de Ensino Superior, Politécnico e Universitário
Torrens University Australia
University North
Faculty of Dentistry
Kristiania University College
Stomatological Hospital, Southern Medical University
Nigerian Institute of Medical Research
Health Policy Research Center
University of Medical Sciences
SBUMS Research Institute for Dental Sciences
Escuela Nacional de Sanidad
Madda Walabu University
Roseman University of Health Sciences
Universidad Autónoma de Manizales
University of The Gambia
Iranian Research Center for HIV/AIDS
National Institute of Legal Medicine Mina Minovici
Indian Institute of Public Health Gandhinagar
Hamdan Bin Mohammed Smart University
University of Al-Fateh Faculty of Medicine
College of Dental Medicine, Qatar University
VNU-University of Medicine and Pharmacy
Shriram Institute for Industrial Research India
College of Nursing, Qatar University
Institute of Public Health
Global Smile Foundation
NSW Brain Clot Bank
King Edward Memorial Hospital
Dr. B. R. Ambedkar State Institute of Medical Sciences (AIMS)
University Hospital Saadna Abdenour
The Interdisciplinary Research Group on Biomedicine and Health
The University of Queensland
King's College London
Harvard University
The University of Edinburgh
Shandong University
Yale School of Medicine
Rijksuniversiteit Groningen
Washington University School of Medicine in St. Louis
Charité – Universitätsmedizin Berlin
Universidad Nacional Autónoma de México
The University of Western Australia
University of Washington School of Medicine
Case Western Reserve University
University of Bern
Universidade Federal de Minas Gerais
Tehran University of Medical Sciences
King Abdulaziz University
Universitetet i Bergen
Klinikum der Universität München
Università degli Studi di Catania
Mahidol University
University of Wollongong
University of Florida College of Medicine
Ain Shams University
Shahid Beheshti University of Medical Sciences
Masaryk University
NYU Langone Health
Flinders University
Western Sydney University
Saveetha Institute of Medical and Technical Sciences
Fundacao Oswaldo Cruz
Universidade Federal de Pernambuco
Barts and The London School of Medicine and Dentistry
Amity University
Faculty of Medicine and Health
Szegedi Tudományegyetem (SZTE)
The University of North Carolina at Charlotte
North-West University
Shiraz University of Medical Sciences
Panjab University
University of Ibadan
University of Portsmouth
Mashhad University of Medical Sciences
Universitas Airlangga
Edith Cowan University
Coventry University
Universitatea de Medicina si Farmacie Carol Davila din Bucuresti
University of Sharjah
Jordan University of Science and Technology
Universität Witten/Herdecke
National Cerebral and Cardiovascular Center
Obafemi Awolowo University
Jazan University
Vietnam National University, Hanoi
Charles Sturt University
Faculty of Medicine, Ain Shams University
Indian Council of Medical Research
LSU Health Sciences Center - New Orleans
University of Lahore
Duy Tan University
King George's Medical University
Bucharest University of Economic Studies
Bahir Dar University
Université Ferhat Abbas Sétif 1
UW Medical Center – Montlake
University of Rajshahi
Tulane University School of Public Health and Tropical Medicine
Dr. D. Y. Patil Vidyapeeth, Pune
Babol University of Medical Sciences
i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Portugal
JSS Academy of Higher Education & Research
University of Michigan School of Dentistry
Khulna University of Engineering and Technology
All India Institute of Medical Sciences, Jodhpur
Shahrekord University of Medical Sciences
Iranian Ministry of Health and Medical Education
Kurdistan University of Medical Sciences
University of Medicine and Pharmacy at HCMC
Faculty of Medical Sciences, University of Kragujevac
Oxford University Clinical Research Unit
Institute for Health Metrics and Evaluation
Adelaide Dental School
Faculty of Medicine and Health
Klinikum Dortmund
Cooperativa de Ensino Superior, Politécnico e Universitário
Torrens University Australia
University North
Faculty of Dentistry
Kristiania University College
Stomatological Hospital, Southern Medical University
Nigerian Institute of Medical Research
Health Policy Research Center
University of Medical Sciences
SBUMS Research Institute for Dental Sciences
Escuela Nacional de Sanidad
Madda Walabu University
Roseman University of Health Sciences
Universidad Autónoma de Manizales
University of The Gambia
Iranian Research Center for HIV/AIDS
National Institute of Legal Medicine Mina Minovici
Indian Institute of Public Health Gandhinagar
Hamdan Bin Mohammed Smart University
University of Al-Fateh Faculty of Medicine
College of Dental Medicine, Qatar University
VNU-University of Medicine and Pharmacy
Shriram Institute for Industrial Research India
College of Nursing, Qatar University
Institute of Public Health
Global Smile Foundation
NSW Brain Clot Bank
King Edward Memorial Hospital
Dr. B. R. Ambedkar State Institute of Medical Sciences (AIMS)
University Hospital Saadna Abdenour
The Interdisciplinary Research Group on Biomedicine and Health
Corresponding Author(s)
Other Contributor(s)
Abstract
Background: The WHO Global Oral Health Action Plan has set an overarching global target of achieving a 10% reduction in the prevalence of oral conditions by 2030. Robust and up-to-date information on the global burden of oral conditions is paramount to monitor progress towards this target. The aim of this systematic data analysis was to produce global, WHO region, and country-level estimates of the prevalence of, and disability-adjusted life-years (DALYs) attributed to, untreated caries, severe periodontitis, edentulism, other oral disorders, lip and oral cavity cancer, and orofacial clefts from 1990 to 2021. Methods: This report is based on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021. Input data were extracted from epidemiological surveys, population-based registries, and vital statistics. Data were modelled with DisMod-MR 2.1, a Bayesian meta-regression modelling tool, to ensure consistency between prevalence, incidence, remission, and mortality estimates for oral conditions. DALYs were estimated as the aggregation of the years of life lost (YLLs) due to premature mortality and years lived with disability (YLDs). YLDs were calculated by multiplying prevalence estimates, the severity of the oral condition's sequelae (disability weight) and duration of the sequelae. Although all oral conditions lead to YLDs, only lip and oral cavity cancer and orofacial clefts lead to YLLs as well. 95% uncertainty intervals (UIs) were generated for every metric with the 25th and 975th ordered 1000 draw values of the posterior distribution. Findings: The combined global age-standardised prevalence of the main oral conditions (untreated caries, severe periodontitis, edentulism, and other oral disorders) was 45 900 (95% UI 42 300 to 49 800) per 100 000 population in 2021, with 3·69 billion (3·40 to 4·00) people affected globally. Untreated dental caries of permanent teeth and severe periodontitis were the most common oral conditions, with a global age-standardised prevalence of 27 500 (24 000 to 32 000) per 100 000 population and 12 500 (10 500 to 14 500) per 100 000 population, respectively. Edentulism, severe periodontitis, and lip and oral cavity cancer caused the highest burden as demonstrated by their counts of DALYs and age-standardised DALY rates. Existing trends for 1990–2021 reveal relatively small changes (upward or downward) in prevalence and burden. Increasing counts of prevalent cases and DALYs were noted for all oral conditions but untreated caries of deciduous teeth (no percentage change in prevalence or DALYs) and orofacial clefts (–68·3% [–79·3 to –46·5] decrease in DALYs). There were decreases in both age-standardised prevalence and DALY rate for untreated caries of permanent teeth and edentulism, no change in both for untreated caries of deciduous teeth and severe periodontitis, an increase in the prevalence but no change in the DALY rate for lip and oral cavity cancer, and no change in the prevalence but a decrease in the DALY rate for orofacial clefts. By WHO region, the African and Eastern Mediterranean regions showed the largest increases in prevalent cases and DALYs for most oral conditions, while the European region showed the smallest increases or no change. The European region was the only region with decreasing age-standardised prevalence of untreated caries in both deciduous (–9·88%; –12·6 to –6·71) and permanent teeth (–5·94% (–8·38 to –3·62). The prevalence and DALY rate of severe periodontitis decreased in the African region, while the prevalence and DALY rate of edentulism decreased in the African region, South-East Asia region, and Western Pacific region. Furthermore, DALY rates of lip and oral cavity cancer decreased in the European region and the region of the Americas, while DALY rates of orofacial clefts decreased in all regions. Interpretation: The minor changes in the burden of oral conditions over the past 30 years demonstrate that past and current efforts to control oral conditions have not been successful and that different approaches are needed. Many countries now face the double challenge of controlling the occurrence of new cases of oral conditions and addressing the huge unmet need for oral health care. Funding: Bill & Melinda Gates Foundation.
