Richards Derek
Centre for Evidence-based Dentistry, Oxford, UK.
Evid Based Dent. 2013;14(2):35. doi: 10.1038/sj.ebd.6400925.
Medline, Embase, Lilacs.
Published and unpublished observational population-based studies presenting information on the prevalence, incidence, case fatality and cause-specific mortality related to untreated caries, severe periodontitis and severe tooth loss between January 1980 and December 2010. There were no language restrictions. Study quality was assessed using the STROBE checklist (http://www.strobe-statement.org/).
Prevalence estimates were calculated on the database for all age-gender-country-year groups using a specifically developed Bayesian meta-regression tool. Disability-adjusted life-years (DALYs) and years lived with disability (YLDs) metrics were used to quantify the disease burden. Disability weights were calculated based on population-based surveys in five countries (USA, Peru, Tanzania, Bangladesh and Indonesia) and an open Internet survey. Uncertainties in estimates were examined using Monte Carlo simulation techniques with uncertainty levels presented as the 2.5th and 97.5th centiles, which can be interpreted as a 95% UI.
Oral diseases remain highly prevalent in 2010 affecting 3.9 billion people. Untreated caries in permanent teeth was the most prevalent condition evaluated for the entire GBD (Global Burden of Disease) 2010 Study with a global prevalence of 35% for all ages combined. Severe periodontitis and untreated caries in deciduous teeth were the 6th and 10th most prevalent conditions, affecting, respectively, 11% and 9% of the global population. Oral conditions combined accounted for 15 million DALYs globally (1.9% of all YLDs and 0.6% of all DALYs), implying an average health loss of 224 years per 100,000 people. DALYs due to oral conditions increased 20.8% between 1990 and 2010, mainly due to population growth and aging. While DALYs due to severe periodontitis and untreated caries increased, those due to severe tooth loss decreased.
The findings highlight the challenge in responding to the diversity of urgent oral health needs world-wide, particularly in developing communities.
医学索引数据库(Medline)、荷兰医学文摘数据库(Embase)、拉丁美洲及加勒比地区卫生科学数据库(Lilacs)。
1980年1月至2010年12月期间发表的及未发表的基于人群的观察性研究,这些研究提供了与未经治疗的龋齿、重度牙周炎和严重牙齿缺失相关的患病率、发病率、病死率和病因特异性死亡率的信息。无语言限制。使用加强流行病学观察性研究报告规范清单(STROBE checklist,http://www.strobe-statement.org/)评估研究质量。
使用专门开发的贝叶斯元回归工具,在数据库中计算所有年龄-性别-国家-年份组的患病率估计值。采用伤残调整生命年(DALYs)和失能生存年数(YLDs)指标来量化疾病负担。伤残权重基于五个国家(美国、秘鲁、坦桑尼亚、孟加拉国和印度尼西亚)的基于人群的调查以及一项公开的互联网调查计算得出。使用蒙特卡罗模拟技术检查估计值的不确定性,不确定性水平以第2.5百分位数和第97.5百分位数表示,可解释为95%的不确定区间(UI)。
2010年口腔疾病仍然高度流行,影响了39亿人。恒牙未经治疗的龋齿是2010年全球疾病负担(GBD)研究评估的所有疾病中最普遍的疾病,所有年龄段的全球患病率为35%。重度牙周炎和乳牙未经治疗的龋齿分别是第6和第10大最普遍的疾病,分别影响全球11%和9%的人口。口腔疾病合计在全球造成1500万伤残调整生命年(占所有失能生存年数的1.9%和所有伤残调整生命年的0.6%),这意味着每10万人平均健康损失224年。1990年至2010年期间,口腔疾病导致的伤残调整生命年增加了20.8%,主要原因是人口增长和老龄化。虽然重度牙周炎和未经治疗的龋齿导致的伤残调整生命年增加,但严重牙齿缺失导致的伤残调整生命年减少。
研究结果凸显了应对全球紧急口腔健康需求多样性方面的挑战,尤其是在发展中社区。