Global, regional, and national burden of caries in primary teeth from 1990 to 2021: results from the global burden of disease study 2021

Abstract

Objective: To investigate the disease burden of caries in primary teeth across global, 21 regions, and 204 countries and territories from 1990 to 2021.

Methods: Data on caries in primary teeth from 1990 to 2021 were obtained from the Global Burden of Disease (GBD) 2021 Study. The global incidence, prevalence of caries in primary teeth associated disability-adjusted life years (DALYs) were analyzed. The burden of the disease and temporal trends were quantified by calculating the age-standardized rate (ASR) and estimated annual percentage changes (EAPCs). To evaluate the distributional disparities in the burden of caries in primary teeth, the slope index of inequality (SII) was used. Additionally, a frontier analysis was performed to pinpoint areas for improvement and examine disparities between countries according to their levels of development.

Results: From 1990 to 2021, the ASR of incidence, prevalence, and DALYs declined globally. In 2021, Eastern Europe had the highest ASR for the incidence and DALYs of caries in primary teeth, with Romania being the country bearing the greatest disease burden. The burden of caries in primary teeth was negatively associated with sociodemographic index (SDI) across the 21 GBD regions. The SII of each indicator decreased from 1990 to 2021. Many countries, regardless of their level of development, have considerable potential to reduce the burden of caries in primary teeth.

Conclusion: The global burden of caries in primary teeth is in a state of alleviation. However, health inequalities in caries in primary teeth related to SDI have continued for over 30 years. The high burden of caries in primary teeth is concentrated in low- and middle-income countries. Active and effective prevention and strong management strategies are needed in specific regions to reduce the burden of caries in primary teeth and achieve equity in health outcomes.

Keywords: Disability-adjusted life years, Health inequalities, Incidence, Primary teeth, Prevalence.

Fig. 1

The disease burden of caries in primary teeth across global, 5 SDI and 21 GBD regions from 1990 to 2021: (A) Incidence of primary tooth caries per calendar year globally and in 5SDI regions; (B) ASIR of caries in primary teeth per calendar year globally and in 5SDI regions; (C) Comparison of incidence cases of caries in primary teeth in the 21 GBD regions in 1990 and 2021; (D) Prevalence of caries in primary teeth per calendar year globally and in 5SDI regions; (E) ASPR of caries in primary teeth per calendar year globally and in 5SDI regions; (F) Comparison of the prevalence cases of caries in primary teeth in the 21 GBD regions in 1990 and 2021; (G) DALYs of primary tooth caries per calendar year globally and in 5SDI regions; (H) ASDR of caries in primary teeth per calendar year globally and in 5SDI regions; (I) Comparison of DALYs of caries in primary teeth in the 21 GBD regions in 1990 and 2021. ASIR, age-standardized incidence rate; ASPR, age-standardized prevalence rate; ASDR, age-standardized disability-adjusted life years rate; DALYs, disability-adjusted life years

Fig. 2

Number and ASR of incidence, prevalence and DALY in 2021, and the estimated annual percentage change (EAPC) analysis of caries in primary teeth across 204 countries and territories, 1990–2021. A Incidence number in 2021; (B) ASIR in 2021; (C) EAPC of ASIR, (D) Prevalence number in 2021; (E) ASPR in 2021; (F) EAPC of ASPR; (G) DALYs in 2021; (H)ASDR in 2021, and (I) EAPC of ASDR. ASR, age-standardized rate; ASIR, age-standardized incidence rate; ASPR, age-standardized prevalence rate; ASDR, age-standardized disability-adjusted life years rate; EAPC, estimated annual percentage change

Fig. 3

Spearman rank correlation analysis between ASIR, ASPR and ASDR across global and 21 GBD regions associated with the SDI. A Negative correlation between ASIR and SDI across the 21 GBD regions and global (r = −0.15, p < 0.001); (B) Negative correlation between ASPR and SDI across the 21 GBD regions and global (r = −0.15, p < 0.001); (C) Negative correlation between ASDR and SDI across the 21 GBD regions and global (r = −0.14, p < 0.001). ASR, age-standardized rate; ASIR, age-standardized incidence rate; ASPR, age-standardized prevalence rate; ASDR, age-standardized disability-adjusted life years rate

Fig. 4

Health inequality regression curves and concentration curves for the incidence, prevalence and DALYs of caries in primary teeth worldwide, 1990 and 2021. A Incidence; (B) Prevalence; (C) DALYs. DALYs, disability-adjusted life years

Fig. 5

Frontier analysis involving SDI and caries in primary teeth burden in 2021. Frontier analysis based on SDI and age-standardized caries in primary teeth DALY rate in 2021 (A, B). The frontier is delineated in solid black color; countries and territories are represented as dots. The top 15 countries with the largest effective difference (largest caries in primary teeth DALYs gap from the frontier) are labeled in black; examples of frontier countries with low SDI (< 0.5) and low effective difference are labeled in blue, and examples of countries and territories with high SDI (> 0.85) and relatively high effective difference for their level of development are labeled in red. Red dots indicate an increase in age-standardized caries in primary teeth DALYs rate from 1990 to 2021; blue dots indicate a decrease in age-standardized caries in primary teeth DALYs rate between 1990 and 2021. SDI: Socio-demographic index; DALYs: disability-adjusted life years