Global periodontitis burden rises sharply

Dental Tribune International

Tue. 23. December 2025

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GUIYANG, China: Severe periodontitis continues to place a growing strain on global oral health. New Global Burden of Disease 2021 data has revealed substantial increases in case numbers and disability over the past three decades. While individual risk levels have changed little overall, demographic shifts mean health systems are facing an expanding periodontal workload worldwide.

An analysis of Global Burden of Disease 2021 data from 204 countries shows that the absolute burden of severe periodontitis increased markedly between 1990 and 2021. Global incident cases rose by more than 76%, from around 50.8 million to almost 89.6 million. Over the same period, disability-adjusted life years (DALYs) attributable to severe periodontitis increased by approximately 91%, reaching 6.9 million in 2021.

Despite these sharp rises in absolute numbers, age-standardised incidence and DALY rates remained largely stable at the global level. Estimated annual percentage changes were small, indicating that population growth and ageing, rather than a substantial worsening of underlying disease risk, are the main drivers of the increasing burden.

The study highlights pronounced regional disparities. South Asia recorded the highest age-standardised incidence and DALY rates in 2021, whereas Oceania consistently showed the lowest burden. In absolute terms, the largest increases in cases and DALYs occurred in India, China and the US, reflecting both demographic expansion and improved detection.

Socioeconomic development played a key role. Countries with a high socio-demographic index generally experienced lower incidence and DALY rates, while low and low-middle index regions carried a disproportionate share of the burden. This inverse relationship suggests that access to preventive services, oral health awareness and broader health system capacity strongly influence periodontal outcomes.

Incidence of severe periodontitis increased with age, peaking in middle adulthood. Males had higher incidence rates at younger ages, but after around 45 years the pattern reversed, and females showed higher rates. Similar trends were observed for DALYs, particularly among older adults.

Although stable age-standardised rates suggest some progress in disease management, the steadily rising absolute burden underscores the need for stronger prevention and control strategies. The findings reinforce the importance of embedding periodontal care within wider non-communicable disease policies to limit future impact, and of tackling shared risk factors such as smoking and vaping and poor oral hygiene and diabetes.

The article, titled “Global and regional burden of periodontal disease in adults (1990-2021)”, was published on 6 December 2025 in International Dental Journal.