A Global Perspective on the Burden of Caries in Permanent Teeth in China (1990-2021): A Population-Based Analysis.

OBJECTIVES: The aim of this study was to assess trends in the burden of caries in permanent teeth in China over the past 32 years and compare them with G20 countries, and project future trends up to 2036. METHOD: Data were obtained from the Global Burden of Disease (GBD) 2021 study. We describe temporal trends in age-standardised incidence, prevalence, and disability-adjusted life years (DALYs) of caries in permanent teeth in China, the Group of Twenty (G20), and globally. Disease burden status was analysed using a combination of age-period-cohort modeling, Joinpoint regression analysis, decomposition analysis, and health inequality analysis. Finally, Bayesian age-period-cohort (BAPC) modeling was applied to predict the burden of permanent dental caries in China by 2036. RESULTS: In 2021, the ASIR, ASPR, and age-standardised DALYs for caries in permanent teeth in China were 19,634.62 cases per 100,000 (95% CI: 16,565.80-23,954.90), 23,759.62 cases per 100,000 (95% CI: 20,403.06-27,675.83), and 19.43 per 100,000 (95% CI: 8.64-37.07), respectively. ASIR and ASPR have declined since 2015. Age-period-cohort analysis identified peak ASIR and ASPR in the 20 to 24 age group. Decomposition analysis indicated that epidemiologic changes and aging drove increased ASIR, while population growth influenced ASPR and age-standardised DALYs. Health inequality analyses showed reduced SDI-related inequality, with a burden concentrated in high SDI countries. A decreasing trend in ASIR and ASPR in China is projected from 2022 to 2036. CONCLUSION: The study reveals the status of the burden of caries in permanent teeth in China and the gap with other countries. CLINICAL SIGNIFICANCE: The burden of permanent dental caries in China is influenced by population aging, growth, and epidemiological shifts. A mismatch between public health systems and economic development necessitates targeted prevention strategies for key populations to reduce health disparities.