Fu Haojie, Li Xinyu, Zhang Ruhong, Zhu Jiaxue, Wang Xudong
Department of Oral and Craniomaxillofacial Surgery, Shanghai Ninth People'S Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Plastic and Reconstructive Surgery, Shanghai Ninth People'S Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
BMC Public Health. 2025 Apr 8;25(1):1316. doi: 10.1186/s12889-025-22566-x.
Periodontal diseases among working-age individuals (15-69 years) represent a significant global health challenge, impacting oral health, quality of life, and economic productivity. Defined according to the 2021 Global Burden of Disease (GBD) framework, periodontal disease in this study encompasses symptoms such as halitosis, altered taste sensation, and occasional gingival bleeding that do not impair daily activities. Despite their prevalence, comprehensive analyses of the global burden of periodontal diseases specifically within this demographic remain limited.
We analyzed data from the GBD 2021 study, examining periodontal disease burden among individuals aged 15-69 years across 204 countries and territories from 1990 to 2021. Age-standardized rates of prevalence, incidence, and disability-adjusted life years (DALYs) were calculated. We employed joinpoint regression analysis to assess temporal trends, decomposition analysis to examine contributing factors, and frontier analysis to evaluate the relationship between disease burden and sociodemographic development.
In 2021, global periodontal disease cases reached 951.3 million (95% UI: 729.0-1,183.3 million), with an age-standardized prevalence rate (ASPR: 17,011.6 per 100,000 persons) and 80.3 million new cases (ASIR: 1,464.7 per 100,000). The burden accounted for 6.2 million DALYs globally (age-standardized DALY rate: 110.8 per 100,000). Asia demonstrated the highest age-standardized rates across all metrics, while Low-middle SDI regions showed the highest ASPR (20,920.5 per 100,000) and ASIR (1,627.9 per 100,000). At the national level, Sierra Leone, Gambia, and Cabo Verde had the highest disease burden. Males consistently showed higher prevalence rates than females, with peak rates observed in the 50-59 age group. Joinpoint regression analysis revealed an overall increasing trend from 1990 to 2021 (AAPC: 0.04, 95% UI: 0.01-0.06), with notable variations across different time periods. While some countries like Qatar, UAE, and Jordan experienced over 500% increase in prevalence since 1990, Pacific island nations like Tonga and Tokelau achieved reductions exceeding 70%. Decomposition analysis identified population growth (74.56%) and aging (23.00%) as primary drivers of increased disease burden.
Our analysis reveals significant global disparities in periodontal disease burden among the working-age population, with concerning increases in many regions from 1990 to 2021. The disproportionate burden in Low-middle SDI regions and South Asia, coupled with the substantial impact of population growth and aging, highlights the urgent need for targeted interventions. While some countries have achieved remarkable reductions in disease burden, the dramatic increases in others underscore the importance of strengthening preventive oral healthcare systems and addressing socioeconomic determinants. These findings emphasize the need for country-specific strategies, particularly in regions with rising burden, and can inform evidence-based policy making to reduce the impact of periodontal diseases on the global workforce.
工作年龄人群（15 - 69岁）中的牙周疾病是一项重大的全球健康挑战，影响口腔健康、生活质量和经济生产力。根据2021年全球疾病负担（GBD）框架定义，本研究中的牙周疾病包括口臭、味觉改变和偶尔牙龈出血等不影响日常活动的症状。尽管其普遍存在，但专门针对这一人群的牙周疾病全球负担的综合分析仍然有限。
我们分析了GBD 2021研究的数据，考察了1990年至2021年期间204个国家和地区15 - 69岁人群的牙周疾病负担。计算了年龄标准化患病率、发病率和伤残调整生命年（DALY）率。我们采用连接点回归分析来评估时间趋势，分解分析来研究影响因素，前沿分析来评估疾病负担与社会人口发展之间的关系。
2021年，全球牙周疾病病例达9.513亿例（95%不确定区间：7.290亿 - 11.833亿例），年龄标准化患病率（ASPR：每10万人中17,011.6例）和8030万新发病例（ASIR：每10万人中1,464.7例）。全球负担为620万DALY（年龄标准化DALY率：每10万人中110.8例）。亚洲在所有指标上的年龄标准化率最高，而低中社会人口指数（SDI）地区的ASPR最高（每10万人中20,920.5例），ASIR最高（每10万人中1,627.9例）。在国家层面，塞拉利昂、冈比亚和佛得角的疾病负担最高。男性的患病率一直高于女性，在50 - 59岁年龄组达到峰值。连接点回归分析显示，1990年至2021年总体呈上升趋势（年度百分比变化率[AAPC]：0.04，95%不确定区间：0.01 - 0.06），不同时间段有显著差异。自1990年以来，卡塔尔、阿联酋和约旦等一些国家的患病率增长超过500%，而汤加和托克劳等太平洋岛国的患病率下降超过70%。分解分析确定人口增长（74.56%）和老龄化（23.00%）是疾病负担增加的主要驱动因素。
我们的分析揭示了工作年龄人口中牙周疾病负担存在显著的全球差异，1990年至2021年期间许多地区出现了令人担忧的增长。低中SDI地区和南亚的负担不成比例，再加上人口增长和老龄化的重大影响，凸显了有针对性干预措施的迫切需求。虽然一些国家在疾病负担方面取得了显著降低，但其他国家的大幅增长凸显了加强预防性口腔保健系统和解决社会经济决定因素的重要性。这些发现强调了针对具体国家的战略的必要性，特别是在负担上升的地区，并可为基于证据的政策制定提供参考，以减少牙周疾病对全球劳动力的影响。
