Global, regional, and national temporal trends of edentulism burden from 1990 to 2021 and predictions to 2050: an age-period-cohort analysis, decomposition analysis and frontier analysis

Objectives

Edentulism affects not only chewing function but also oral health, facial morphology, and mental health. It's crucial to conduct an overview and in - depth analysis of the prevalence of edentulism and Disability - Adjusted Life Years (DALYs) at global, regional, and national levels from 1990 to 2021.

Methods

This study sourced edentulism data from the 2021 Global Burden of Disease (GBD) database, spanning 1990 - 2021. A Joinpoint regression model, with annual percentage change (APC) and average annual percentage change (AAPC) as indicators, identified inflection points in the time - series. The slope index of inequality (SII) and concentration index (CI) were calculated to evaluate global health inequalities. Das Gupta’s decomposition method and frontier analysis evaluated the link between edentulism burden and sociodemographic development. Finally, a Bayesian age-period-cohort (BAPC) model predicted future prevalence and incidence trends over the next decades.

Results

In 2021, the global prevalence of edentulism was reported at 353,000,621 cases (95% uncertainty interval [UI]: 300,591,593–416,167,869), with 9,590,987 DALY (95% UI: 6,202,444–13,470,473), nearly double the figures from 1990. Decomposition analysis highlighted population aging and growth made significant contributions. Health inequality analysis revealed that the SII for DALYs was 93.497 (95% CI: 71.486–115.508) in 1990 and -18.412 (95% CI: -92.144–55.320) in 2021. From 1990 to 2021, the CI for DALYs showed an upward trend, changing from -0.202 in 1990 to 0.353 in 2021. BAPC model projects age-standardized prevalence rates(ASPR) decline by 2050, with higher burden in over 60 years old.