Worldwide changes in the burden of deciduous and permanent tooth caries and periodontal disease in children and adolescents aged 0-19 years from 1990 to 2021.

OBJECTIVES: This study assessed the global burden of two major oral conditions: dental caries (including caries of deciduous teeth (CDT) and caries of permanent teeth (CPT)) and periodontal disease (PD) among children and adolescents aged 0-19 years. METHODS: Data were extracted from the Global Burden of Disease Study (GBD) 2021. We examined the number and age-standardised rates (ASRs) of prevalence, incidence, and disability-adjusted life years (DALYs) for these two major oral conditions: dental caries (including CDT and CPT) and periodontal disease across different age groups, sexes, social development index (SDI) levels, regions, and countries. RESULTS: The age-standardized global rates per 100,000 population reached 19,903.7 (prevalence), 47,546.7 (incidence), and 7.6 (DALYs) for CDT; 15,440.1, 24,083.2, and 15.5 for CPT; and 309.0, 103.3, and 2.1 for PD in 2021, respectively. The overall number of prevalent cases reached 524.6 million for CDT, 407 million for CPT, and 8.1 million for PD. From 1990 to 2021, CDT and CPT showed an overall decline in prevalence and DALYs, whereas PD exhibited an upward trend across all metrics. In addition, The highest CDT burden was observed in Central Asia, while Western Europe had the lowest rates in 21 regions. For CPT, Andean Latin America and Central Europe recorded the highest prevalence and incidence, whereas East Asia had the lowest. South Asia contributed the largest absolute number of CDT and CPT cases globally. Across 204 countries, Georgia and Paraguay had the highest CDT and CPT prevalence rates, respectively, while Denmark and Taiwan (Province of China) had the lowest. The SDI and regions analysis revealed distinct patterns: high-middle SDI regions exhibited the greatest CDT and CPT burden, whereas high SDI regions consistently showed the lowest prevalence and DALY rates aged 0 to 19 years. From 1990 to 2021, the most significant declines in CDT burden occurred in low-middle SDI regions, while CPT increased most prominently in low SDI regions. By contrast, PD showed consistent growth globally, with Central Asia bearing the heaviest burden and Western Europe the lightest. CONCLUSIONS: Although the prevalence of dental caries and periodontal disease among children and adolescents has declined over the past three decades, the overall burden remains substantial. These findings underscore the need to sustain and strengthen global and regional oral health initiatives targeting younger populations.