Global burden of oral conditions in 1990-2010: a systematic analysis
TL;DR: The global burden of untreated caries, severe periodontitis, and severe tooth loss in 2010 is reported on and the challenge in responding to the diversity of urgent oral health needs worldwide is highlighted, particularly in developing communities.
Abstract: The Global Burden of Disease (GBD) 2010 Study produced comparable estimates of the burden of 291 diseases and injuries in 1990, 2005, and 2010. This article reports on the global burden of untreated caries, severe periodontitis, and severe tooth loss in 2010 and compares those figures with new estimates for 1990. We used disability-adjusted life-years (DALYs) and years lived with disability (YLDs) metrics to quantify burden. Oral conditions affected 3.9 billion people, and untreated caries in permanent teeth was the most prevalent condition evaluated for the entire GBD 2010 Study (global prevalence of 35% for all ages combined). Oral conditions combined accounted for 15 million DALYs globally (1.9% of all YLDs; 0.6% of all DALYs), implying an average health loss of 224 years per 100,000 population. 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. DALYs differed by age groups and regions, but not by genders. The findings highlight the challenge in responding to the diversity of urgent oral health needs worldwide, particularly in developing communities.
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Griffith University1, University of Glasgow2, University of Pittsburgh3, Trinity College, Dublin4, University College London5, Public Health Foundation of India6, Heidelberg University7, Radboud University Nijmegen8, Universidade Federal do Rio Grande do Sul9, National University of Colombia10, University of California, San Francisco11, New York University12, McGill University13
TL;DR: The extent and consequences of oral diseases, their social and commercial determinants, and their ongoing neglect in global health policy are described to highlight the urgent need to address oral diseases among other NCDs as a global health priority.
1,349 citations
TL;DR: Policy makers need to be aware of a predictable increasing burden of SP due to the growing world population associated with an increasing life expectancy and a significant decrease in the prevalence of total tooth loss throughout the world from 1990 to 2010.
Abstract: We aimed to consolidate all epidemiologic data about severe periodontitis (SP) and, subsequently, to generate internally consistent prevalence and incidence estimates for all countries, 20 age groups, and both sexes for 1990 and 2010. The systematic search of the literature yielded 6,394 unique citations. After screening titles and abstracts, we excluded 5,881 citations as clearly not relevant to this systematic review, leaving 513 for full-text review. A further 441 publications were excluded following the validity assessment. A total of 72 studies, including 291,170 individuals aged 15 yr or older in 37 countries, were included in the metaregression based on modeling resources of the Global Burden of Disease 2010 Study. SP was the sixth-most prevalent condition in the world. Between 1990 and 2010, the global age-standardized prevalence of SP was static at 11.2% (95% uncertainty interval: 10.4%-11.9% in 1990 and 10.5%-12.0% in 2010). The age-standardized incidence of SP in 2010 was 701 cases per 100,000 person-years (95% uncertainty interval: 599-823), a nonsignificant increase from the 1990 incidence of SP. Prevalence increased gradually with age, showing a steep increase between the third and fourth decades of life that was driven by a peak in incidence at around 38 yr of age. There were considerable variations in prevalence and incidence between regions and countries. Policy makers need to be aware of a predictable increasing burden of SP due to the growing world population associated with an increasing life expectancy and a significant decrease in the prevalence of total tooth loss throughout the world from 1990 to 2010.
1,346 citations
Cites background from "Global burden of oral conditions in..."
..., prevalence, incidence, remission, duration, case fatality, and cause-specific mortality) between January 1980 and December 2010 regardless of language, geography, age, sex, or publication status (Marcenes et al., 2013)....
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...…identify all studies presenting SP-related descriptive epidemiology data (e.g., prevalence, incidence, remission, duration, case fatality, and cause-specific mortality) between January 1980 and December 2010 regardless of language, geography, age, sex, or publication status (Marcenes et al., 2013)....
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TL;DR: There is evidence that the burden of untreated caries is shifting from children to adults, with 3 peaks in prevalence at ages 6, 25, and 70 y, and there were considerable variations in prevalence and incidence between regions and countries.
Abstract: We aimed to consolidate all epidemiologic data about untreated caries and subsequently generate internally consistent prevalence and incidence estimates for all countries, 20 age groups, and both sexes for 1990 and 2010. The systematic search of the literature yielded 18,311 unique citations. After screening titles and abstracts, we excluded 10,461 citations as clearly irrelevant to this systematic review, leaving 1,682 for full-text review. Furthermore, 1,373 publications were excluded following the validity assessment. Overall, 192 studies of 1,502,260 children aged 1 to 14 y in 74 countries and 186 studies of 3,265,546 individuals aged 5 y or older in 67 countries were included in separate metaregressions for untreated caries in deciduous and permanent teeth, respectively, using modeling resources from the Global Burden of Disease 2010 study. In 2010, untreated caries in permanent teeth was the most prevalent condition worldwide, affecting 2.4 billion people, and untreated caries in deciduous teeth was the 10th-most prevalent condition, affecting 621 million children worldwide. The global age-standardized prevalence and incidence of untreated caries remained static between 1990 and 2010. There is evidence that the burden of untreated caries is shifting from children to adults, with 3 peaks in prevalence at ages 6, 25, and 70 y. Also, there were considerable variations in prevalence and incidence between regions and countries. Policy makers need to be aware of a predictable increasing burden of untreated caries due to population growth and longevity and a significant decrease in the prevalence of total tooth loss throughout the world from 1990 to 2010.
1,020 citations
TL;DR: Great efforts and potentially different approaches are needed if the oral health goal of reducing the level of oral diseases and minimizing their impact is to be achieved by 2020, despite some challenges with current measurement methodologies for oral diseases.
Abstract: The Global Burden of Disease 2015 study aims to use all available data of sufficient quality to generate reliable and valid prevalence, incidence, and disability-adjusted life year (DALY) estimates of oral conditions for the period of 1990 to 2015. Since death as a direct result of oral diseases is rare, DALY estimates were based on years lived with disability, which are estimated only on those persons with unmet need for dental care. We used our data to assess progress toward the Federation Dental International, World Health Organization, and International Association for Dental Research's oral health goals of reducing the level of oral diseases and minimizing their impact by 2020. Oral health has not improved in the last 25 y, and oral conditions remained a major public health challenge all over the world in 2015. Due to demographic changes, including population growth and aging, the cumulative burden of oral conditions dramatically increased between 1990 and 2015. The number of people with untreated oral conditions rose from 2.5 billion in 1990 to 3.5 billion in 2015, with a 64% increase in DALYs due to oral conditions throughout the world. Clearly, oral diseases are highly prevalent in the globe, posing a very serious public health challenge to policy makers. Greater efforts and potentially different approaches are needed if the oral health goal of reducing the level of oral diseases and minimizing their impact is to be achieved by 2020. Despite some challenges with current measurement methodologies for oral diseases, measurable specific oral health goals should be developed to advance global public health.
1,018 citations
Cites background or methods or result from "Global burden of oral conditions in..."
...…of countries for which any incidence, prevalence, remission, or excess mortality data were available—increased over that represented by the GBD 2010 study (Marcenes et al. 2013), data were still scarce in some geographies (GBD 2015 Disease and Injury Incidence and Prevalence Collaborators 2016)....
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...This report supersedes our previous GBD report (Marcenes et al. 2013)....
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...Full case definitions and inclusion/ exclusion criteria for literature review and definition of disability associated with oral conditions were consistent with previous analyses (Marcenes et al. 2013) and are presented in Appendix 1....
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...The major challenge remained inherent to the availability and reporting of oral conditions (Marcenes et al. 2013; Kassebaum et al. 2014a, 2014b, 2015)....
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TL;DR: A strong and coherent body of evidence allows identification of actionable preventive, diagnostic and therapeutic strategies to effectively promote periodontal health and general wellbeing, and better manage the socio-economic consequences.
Abstract: Background
The global burden of periodontal diseases remains high. Population growth trends, changes in risk factors and improved tooth retention will increase the socio-economic burden of periodontitis that is responsible for 3,5 million years lived with disability, 54 billion USD/year in lost productivity and a major portion of the 442 billion USD/year cost for oral diseases.
Methods
In the context of the Milan World Exhibition 2015 “Feeding the Planet, Energy for Life”, a green paper was developed and offered for global consultation by the European Federation of Periodontology. The final draft was endorsed by professional organizations around the world and is presented to stakeholders as a call for global action.
Results
Specific actions for the public, policymakers, educators, and professional organizations have been identified in the areas of prevention, detection and care. These actions align public interest and knowledge, need for self-care, professional intervention and policies to the best scientific evidence to proactively promote periodontal health and effectively manage the global burden of periodontal diseases, in accordance with WHO/UN priorities and strategies for tackling common non-communicable diseases (NCDs) via the Common Risk Factor Approach.
Conclusions
A strong and coherent body of evidence allows identification of actionable preventive, diagnostic and therapeutic strategies to effectively promote periodontal health and general wellbeing, and better manage the socio-economic consequences. Action requires consideration of the specific national scenarios.
This article is protected by copyright. All rights reserved.
608 citations
Cites background from "Global burden of oral conditions in..."
...…the 6th most prevalent disease worldwide, with an overall prevalence of 11.2% and around 743 million people affected, and (ii) the global burden of periodontal disease increased by 57.3% from 1990 to 2010 (Jin et al., 2016 ; Kassebaum et al., 2014a ; Marcenes et al., 2013 ; Murray et al., 2012 )....
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References
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01 Jan 2013
9,769 citations
"Global burden of oral conditions in..." refers methods in this paper
...Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]....
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...Two trained reviewers working independently and in duplicate searched the literature following the Cochrane Handbook (Higgins and Green, 2011), extracted the data, and assessed the validity of publications retrieved....
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Book•
01 Jan 1996
TL;DR: This is the first in a planned series of 10 volumes that will attempt to "summarize epidemiological knowledge about all major conditions and most risk factors" and use historical trends in main determinants to project mortality and disease burden forward to 2020.
Abstract: This is the first in a planned series of 10 volumes that will attempt to "summarize epidemiological knowledge about all major conditions and most risk factors;...generate assessments of numbers of deaths by cause that are consistent with the total numbers of deaths by age sex and region provided by demographers;...provide methodologies for and assessments of aggregate disease burden that combine--into the Disability-Adjusted Life Year or DALY measure--burden from premature mortality with that from living with disability; and...use historical trends in main determinants to project mortality and disease burden forward to 2020." This first volume includes chapters summarizing results from the project as a whole. (EXCERPT)
7,154 citations
"Global burden of oral conditions in..." refers background in this paper
...They provide governments and national and international non-governmental agencies with the evidence-based data from which to determine priorities for research, development, policies, and funding (Murray and Lopez, 1996a; Murray et al., 2012a)....
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...The burden of oral diseases as estimated by the GBD 1990 Study was moderate (Murray and Lopez, 1996b)....
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...The GBD 1990 Study assessed the burden of oral diseases in 8 major world regions (World Bank, 1993; Murray and Lopez, 1996b, 1997)....
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TL;DR: Prevalence and severity of health loss were weakly correlated and age-specific prevalence of YLDs increased with age in all regions and has decreased slightly from 1990 to 2010, but population growth and ageing have increased YLD numbers and crude rates over the past two decades.
7,021 citations
"Global burden of oral conditions in..." refers background in this paper
...Disability refers to any short- or long-term health loss other than death (Murray and Lopez, 1997; Vos et al., 2012)....
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...Oral conditions accounted for more YLDs than 25 of 28 categories of cancer, and only stomach, liver and trachea, and bronchus and lung cancers ranked higher than oral conditions (Vos et al., 2012)....
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Journal Article•
TL;DR: In this article, a comprehensive update of disease burden worldwide incorporating a systematic reassessment of disease and injury-specific epidemiology has been done since the 1990 study, and the authors aimed to calculate disease burden globally and for 21 regions for 1990, 2005, and 2010 with methods to enable meaningful comparisons over time.
7,020 citations
TL;DR: The results for 1990 and 2010 supersede all previously published Global Burden of Disease results and highlight the importance of understanding local burden of disease and setting goals and targets for the post-2015 agenda taking such patterns into account.
6,861 citations