Temporal trends in cross-country inequalities of permanent caries burden from 1990 to 2021: a secondary analysis of the global burden of disease study 2021

Abstract Objective To evaluate the changes in cross-national disparities in the burden of Permanent caries (PC) from 1990 to 2021. Methods We extracted the annual incidence and years lived with disability (YLDs), including their estimated annual percentage changes (EAPCs), categorized by year, age,...

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Main Authors: Shuang Zhang, Si-Yu Liu, Zhi-Hui Xu, Tian-Tian Li, Shuang-Nan Li, Yan-Li Song, Ya-Xi Suo, Long Xie
Format: Article
Language:English
Published: BMC 2025-08-01
Series:BMC Oral Health
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Online Access:https://doi.org/10.1186/s12903-025-06606-x
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author Shuang Zhang
Si-Yu Liu
Zhi-Hui Xu
Tian-Tian Li
Shuang-Nan Li
Yan-Li Song
Ya-Xi Suo
Long Xie
author_facet Shuang Zhang
Si-Yu Liu
Zhi-Hui Xu
Tian-Tian Li
Shuang-Nan Li
Yan-Li Song
Ya-Xi Suo
Long Xie
author_sort Shuang Zhang
collection DOAJ
description Abstract Objective To evaluate the changes in cross-national disparities in the burden of Permanent caries (PC) from 1990 to 2021. Methods We extracted the annual incidence and years lived with disability (YLDs), including their estimated annual percentage changes (EAPCs), categorized by year, age, geographical region, and socio-demographic index (SDI) from the Global Burden of Disease 2021. Correlation analysis was performed to evaluate the relationships among age-standardized rates (ASRs) of incidence, YLDs, and SDI. To assess the distributional inequalities in the burden of PC, we employed both the slope index of inequality (SII) and the concentration index. Furthermore, a frontier analysis was conducted to identify areas needing improvement and to investigate disparities among countries based on their development levels. Results From 1990 to 2021, the age-standardized incidence rate (ASIR) of PC globally showed an upward trend with an estimated annual percentage change (EAPC) of 0.23% (0.20 to 0.26). In contrast, the age-standardized YLDs for PC remained stable with a corresponding EAPC of -0.03% (-0.08 to 0.02). The SDI was positively correlated with ASIR, while it was negatively correlated with ASR of YLDs. The SII decreased from 9.51 in 1990 to 7.30 and the concentration index increased from 0.04 in 1990 to 0.08 in 2021 for PC. Regardless of their development levels, numerous countries possess substantial potential for decreasing the burden associated with PC. Conclusion Although the ASIR of global PC showed an upward trend from 1990 to 2021, the ASR of YLDs displayed a stable trend, with a more pronounced decrease in high and high-middle SDI regions. This study highlights a persistent, though gradually narrowing, inequality in the global burden of PC over the past 32 years.
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issn 1472-6831
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spelling doaj-art-1c7d71124c87400c87c8bd2bab8f46222025-08-20T04:02:41ZengBMCBMC Oral Health1472-68312025-08-0125111210.1186/s12903-025-06606-xTemporal trends in cross-country inequalities of permanent caries burden from 1990 to 2021: a secondary analysis of the global burden of disease study 2021Shuang Zhang0Si-Yu Liu1Zhi-Hui Xu2Tian-Tian Li3Shuang-Nan Li4Yan-Li Song5Ya-Xi Suo6Long Xie7State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan UniversityDepartment of Fifth Outpatient, The Affiliated Stomatological Hospital of Nanjing Medical UniversityState Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan UniversityState Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan UniversityState Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan UniversityState Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan UniversityState Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan UniversityState Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan UniversityAbstract Objective To evaluate the changes in cross-national disparities in the burden of Permanent caries (PC) from 1990 to 2021. Methods We extracted the annual incidence and years lived with disability (YLDs), including their estimated annual percentage changes (EAPCs), categorized by year, age, geographical region, and socio-demographic index (SDI) from the Global Burden of Disease 2021. Correlation analysis was performed to evaluate the relationships among age-standardized rates (ASRs) of incidence, YLDs, and SDI. To assess the distributional inequalities in the burden of PC, we employed both the slope index of inequality (SII) and the concentration index. Furthermore, a frontier analysis was conducted to identify areas needing improvement and to investigate disparities among countries based on their development levels. Results From 1990 to 2021, the age-standardized incidence rate (ASIR) of PC globally showed an upward trend with an estimated annual percentage change (EAPC) of 0.23% (0.20 to 0.26). In contrast, the age-standardized YLDs for PC remained stable with a corresponding EAPC of -0.03% (-0.08 to 0.02). The SDI was positively correlated with ASIR, while it was negatively correlated with ASR of YLDs. The SII decreased from 9.51 in 1990 to 7.30 and the concentration index increased from 0.04 in 1990 to 0.08 in 2021 for PC. Regardless of their development levels, numerous countries possess substantial potential for decreasing the burden associated with PC. Conclusion Although the ASIR of global PC showed an upward trend from 1990 to 2021, the ASR of YLDs displayed a stable trend, with a more pronounced decrease in high and high-middle SDI regions. This study highlights a persistent, though gradually narrowing, inequality in the global burden of PC over the past 32 years.https://doi.org/10.1186/s12903-025-06606-xHealth inequality analysisPermanent teethIncidenceYears lived with disabilityDiseases burden
spellingShingle Shuang Zhang
Si-Yu Liu
Zhi-Hui Xu
Tian-Tian Li
Shuang-Nan Li
Yan-Li Song
Ya-Xi Suo
Long Xie
Temporal trends in cross-country inequalities of permanent caries burden from 1990 to 2021: a secondary analysis of the global burden of disease study 2021
BMC Oral Health
Health inequality analysis
Permanent teeth
Incidence
Years lived with disability
Diseases burden
title Temporal trends in cross-country inequalities of permanent caries burden from 1990 to 2021: a secondary analysis of the global burden of disease study 2021
title_full Temporal trends in cross-country inequalities of permanent caries burden from 1990 to 2021: a secondary analysis of the global burden of disease study 2021
title_fullStr Temporal trends in cross-country inequalities of permanent caries burden from 1990 to 2021: a secondary analysis of the global burden of disease study 2021
title_full_unstemmed Temporal trends in cross-country inequalities of permanent caries burden from 1990 to 2021: a secondary analysis of the global burden of disease study 2021
title_short Temporal trends in cross-country inequalities of permanent caries burden from 1990 to 2021: a secondary analysis of the global burden of disease study 2021
title_sort temporal trends in cross country inequalities of permanent caries burden from 1990 to 2021 a secondary analysis of the global burden of disease study 2021
topic Health inequality analysis
Permanent teeth
Incidence
Years lived with disability
Diseases burden
url https://doi.org/10.1186/s12903-025-06606-x
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