Over the past three decades, limited action has been taken to address global oral health issues. Without significant intervention, this trend is likely to persist, according to research recently published in The Lancet.
Edentulism, severe periodontitis, and lip and oral cavity cancer may pose the greatest burden, the authors wrote.
"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," wrote the authors, led by Eduardo Bernabe of the Royal London Dental Hospital in the United Kingdom. (Lancet, February 27, 2025).
This study was based on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021. Input data came from epidemiological surveys, population-based registries, and vital statistics. A regression tool was used to model data and ensure consistency in prevalence, incidence, remission, and mortality estimates for oral conditions, they wrote.
Disability-adjusted life years (DALYs) were calculated by combining years of life lost (YLLs) due to premature death and years lived with disability (YLDs). While all oral conditions contribute to YLDs, only lip and oral cavity cancer and orofacial clefts also result in YLLs.
In 2021, the global age-standardized prevalence of major oral conditions, including untreated caries, severe periodontitis, edentulism, and other oral disorders was 45,900 (95% uncertainty intervals [UI] per 100,000 people, affecting 3.69 billion individuals worldwide). Untreated dental caries of permanent teeth had a prevalence of 27,500 per 100,000, while severe periodontitis affected 12,500 per 100,000, they wrote.
Furthermore, edentulism, severe periodontitis, and lip and oral cavity cancer had the highest burden based on DALY counts and rates. Between 1990 and 2021, the prevalence and burden of most oral conditions changed slightly, with overall increases in prevalent cases and DALYs, except for orofacial clefts, which saw a DALY reduction of -68.3%.
However, the study had limitations. Some countries had limited oral health data, and available data often did not align with GBD case definitions or measurement methods, the authors added.
"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," they concluded.
