Periodontal disease is very common and various studies have suggested that between 5-20% of any population suffers with severe periodontitis (SP). The aim of this review was to consolidate all epidemiologic data about SP and, generate internally consistent prevalence and incidence estimates for all countries, 20 age groups, and both sexes for 1990 and 2010.

Methods

Searches were conducted in Medline, Embase, and LILACS and chief dental officers worldwide were written to asking for conference reports, theses, government reports, and unpublished survey data. Searches, study selection, and data abstraction were carried out independently by two reviewers. All descriptive epidemiology studies presenting SP were considered. Severe periodontitis was defined for this review as a CPITN score of 4, a clinical attachment loss (AL) more than 6 mm, or a gingival pocket depth (PD) more than 5 mm. Meta-regressions were conducted based on modeling resources of the Global Burden of Disease 2010 Study

Results

• 72 studies involving 291,170 patients were included.
• 65 studies were prevalence studies
•  In 2010, SP was the sixth-most prevalent condition, affecting 10.8% (95% uncertainty interval [UI]: 10.1%-11.6%) or 743 million people worldwide.
• Between 1990 and 2010, the global age-standardized prevalence of SP in the entire population was static at 11.2% (95% UI: 10.4%-11.9% in 1990 and 10.5%-12.0% in 2010) a non significant increase from the 1990 incidence of SP.
• The age-standardized incidence of SP in 2010 was 701 cases per 100,000 person-years (95% uncertainty interval: 599-823), a non significant increase from the 1990 incidence of SP.
• Prevalence increased gradually with age, showing a steep increase between the third and fourth decades of life that was driven by a peak in incidence at around 38yr of age.

Conclusions

The authors concluded

In conclusion, policy makers need to be aware of a predictable increasing burden of severe periodontitis  due to the growing world population associated with an increasing life expectance and a massive decrease in the prevalence of tooth loss throughout the world from 1990 to 2010. These changes underscore the enormous public health challenge posed by SP and are a microcosm of the epidemiologic transition to non-communicable diseases occurring in many countries.

Commentary

The methodology of this review enabled the researches to identify the best available data sources. Although as they themselves highlight there are potential problems with both the measurement and reporting of SP. There are also problems caused by the lack of agreement on how to measure periodontal health consistently. The vast majority of the studies are also cross-sectional with only 2 of the studies included measuring incidence.

Links

Kassebaum NJ, Bernabé E, Dahiya M, Bhandari B, Murray CJ, Marcenes W. Global Burden of Severe Periodontitis in 1990-2010: A Systematic Review and Meta-regression. J Dent Res. 2014 Sep 26. pii: 0022034514552491. [Epub ahead of print] Review. PubMed PMID: 25261053.