Trends in the burden of untreated caries of permanent teeth in China, 1993-2017: An age-period-cohort modeling study

Abstract

Introduction: This study aims to identify the trends in incidence and prevalence of untreated caries in permanent teeth in China during 1993–2017.

Methods: Data representing >31 billion person-years of observation from the Global Burden of Disease study 2017 were analyzed. Age–period–cohort modeling was performed to investigate the trends in untreated caries that may be of value to policymakers. Analyses were conducted in 2019–2020.

Results: Prevalence of untreated caries in permanent teeth decreased steadily before 2010; after which, an increasing trend was noted without the signs of plateauing (age-adjusted annual percentage change, 1993–2017: −0.54%, 95% CI= −0.75%, −0.33%; declining period RR, 1993–2017: p=6.33 × 10−9; declining cohort RR, 1993–2017: p=3.46 × 10−6). Although untreated caries prevalence declined overall among multiple age groups (p<0.05), an increase in prevalence after 2010 was noted. This was driven by the deteriorating oral health condition in recent birth cohorts aged <25 years. Estimates of the longitudinal age trend (incidence: −0.013, 95% CI= −0.015, −0.011; prevalence: −0.0038, 95% CI= −0.0060, −0.0015) suggested that the highest untreated caries incidence and prevalence rate were both observed among young adults aged 20–24 years. No differences between incidence and prevalence of untreated caries were observed among adults aged >55 years (p>0.05).

Conclusions: The increased burden of untreated caries in China after 2010 is driven by those aged <25 years. Untreated caries data from the Global Burden of Disease study are a valid complement to the data from the Chinese National Oral Health Epidemiology Surveys.