Despite advancements in oral healthcare, the burden of these conditions remains a persistent concern globally. As a public health issue, understanding their prevalence and future projections is critical to strategize effective preventive and care measures.
A recent study by Nascimiento et al. (2024) offers updated estimates and future projections on the prevalence of severe periodontitis and edentulism based on the Global Burden of Disease (GBD) 2021 study findings.

Periodontitis and edentulism: Global Health concerns

As a dental professional, staying informed about the rising prevalence of periodontitis and edentulism is crucial. Left untreated, severe periodontitis can lead to tooth loss and eventually even edentulism, significantly affecting patients’ nutrition, speech, and self-esteem, and increasing risks of systemic diseases.
Despite advancements in care, the impact of these conditions continues to be felt globally, especially among aging populations and in low- and middle-income countries.

According to The Economist in 2021, periodontitis ranks as the sixth-most prevalent health condition globally, with an estimated 11% of the global population – approximately 743 million people – affected by a severe form, as reported by the Global Burden of Disease Study 2017.

Reports like the WHO’s 2022 Global Oral Health Status express the urgent need for action, including the role of dental professionals as significant stakeholders in improving public health outcomes.

What is the Global Burden of Disease 2021 Study?

The Global Burden of Disease (GBD) 2021 Study is a comprehensive analysis that measures global health loss due to diseases, injuries, and risk factors. It updates findings from previous cycles, including the GBD 2019 study, and provides insights into the prevalence and impact of 369 diseases and injuries across 204 countries. The study uses Disability-Adjusted Life Years (DALYs) as a core metric to quantify health loss, combining years lost to premature mortality and years lived with disability (YLD).

The 2021 study introduces new data sources, additional causes, and refined age-group analyses, especially for young children. It also examines the direct and indirect impacts of the COVID-19 pandemic, identifying it as the leading contributor to health loss globally in 2021. The study serves as a crucial reference for policymakers and healthcare practitioners to guide resource allocation and health strategies at local and global levels.

An overview of findings from the GBD 2021 study

The following are key findings from the GBD 2021 study, including projections to 2050.

1. Severe periodontitis

Severe periodontitis is a critical public health concern due to its widespread prevalence and associated health impacts. As of 2021, over 1 billion individuals worldwide were living with severe periodontitis, resulting in a global age-standardised prevalence of 12.50 percent. The highest prevalence rates were reported in South Asia, where 17.57% of the population is affected. Notably, there were approximately 90 million new cases that year, with a global age-standardised incidence rate of 1.07 percent.

2. Demographic trends

In terms of sex, while severe periodontitis affects both males and females, there is a slightly higher prevalence among males across all age groups. The peak age range for the condition is between 50 and 64 years, after which the prevalence declines and reaches a plateau by the age of 80. This pattern points to the increased vulnerability of middle-aged and older populations to severe periodontitis and its complications.

3. Health burden of severe periodontitis

In 2021, severe periodontitis accounted for 6.90 million YLDs globally, translating to an age-standardised YLD rate of 80.89 per 100,000 individuals. These numbers are a stark reminder of the substantial impact of severe periodontitis on daily functioning, including eating, speaking, and social interactions, which collectively reduce the overall quality of life for affected individuals.

4. Trends over time and future projections (1990–2050)

The prevalence and incidence of severe periodontitis have nearly doubled since 1990, although the age-standardised rates have remained relatively stable, with a minor increase of 1.76% in prevalence and 0.01% in incidence. The ageing global population and shifts in risk factors are expected to drive a continued rise in the number of cases. By 2050, it is projected that over 1.56 billion people will be living with severe periodontitis, representing a 44.32% increase from 2021. The number of new cases is also expected to reach 120.45 million by 2050, with an annual growth rate of 3.06 percent.

Despite these rising case numbers, age-standardised prevalence and incidence rates are forecasted to remain stable at the global level, at 13.10% and 1.06%, respectively. However, the total number of YLDs is anticipated to rise by 43.34%, reaching 10.06 million by 2050.

Severe periodontitis is expected to become the 30th most impactful Level 4 disease or condition globally, increasing its contribution to the global burden of disease.

5. Edentulism

Edentulism, or the complete loss of natural teeth, is a major global health issue that impacts the quality of life and general well-being of millions of people.

The condition not only affects oral function but is also linked to systemic health issues and psychosocial challenges, making it a critical focus for dental professionals and public health policymakers.

In 2021, approximately 353 million people worldwide were edentulous, leading to a global age-standardised prevalence rate of 4.11 percent. Latin America and the Caribbean reported the highest prevalence, at 7.39%, indicating a significant regional disparity in oral health outcomes. Additionally, 26.53 million new cases of edentulism were identified, with a global age-standardised incidence rate of 0.31 percent.

6. Edentulism prevalence and incidence

Edentulism resulted in 9.59 million YLDs in 2021, with an age-standardised YLD rate of 111.51 per 100,000 individuals. This substantial burden placed edentulism as the 24th most impactful Level 4 disease or condition globally.

7. Trends over time and future projections (1990–2050)

From 1990 to 2021, the total number of prevalent and incident cases of edentulism nearly doubled. However, similar to severe periodontitis, the age-standardised prevalence and incidence rates of edentulism have remained relatively stable over time.

Looking forward to 2050, the number of edentulous individuals is projected to reach nearly 661 million, marking an 83.40% increase from 2021. This growth translates to an annual increase of 5.11%, driven primarily by an ageing global population. Notably, China is expected to house 19.67% of the world’s edentulous population by 2050, with 130.23 million affected individuals.

Incident cases are also expected to rise significantly, reaching 42.41 million by 2050– a 56.82% increase compared to 2021. Despite these rising numbers, the global age-standardized prevalence and incidence rates are forecasted to remain relatively stable at 4.18% and 0.29%, respectively.

By 2050, the global number of YLDs attributable to edentulism is expected to increase by 81.35%, climbing from 9.59 million in 2021 to 17.78 million. As a result, edentulism is projected to become the 15th most impactful Level 4 disease or condition worldwide, moving up nine positions in the global ranking since 2021.

8. The growing need for comprehensive oral health strategies

The findings from the Global Burden of Disease 2021 Study underscore the significant global prevalence and impact of severe periodontitis and edentulism. Both conditions impose a substantial health burden, with millions of individuals affected and millions more expected to be impacted by 2050.
 
Dental professionals play a crucial role in early diagnosis, preventive care, and the comprehensive management of periodontitis and edentulism. Addressing these conditions effectively will require targeted public health strategies, improved access to dental care, and greater awareness of the long-term implications of poor oral health. A proactive, patient-centred approach will be essential to mitigating the rising burden and improving overall health outcomes for future generations.

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