Evolving Patterns of Oral Disease Burden in China, 1990–2021: Evidence From the Global Burden of Disease Study

Objectives: To comprehensively analyse the burden of five oral diseases in China, including caries of deciduous teeth, caries of permanent teeth, periodontal diseases, edentulism, and other oral disorders; compare their trends with global patterns from 1990 to 2021 using Global Burden of Disease 2021 data; and project future changes to inform targeted health policies. Methods: The age-standardized rates of incidence (ASIR), prevalence (ASPR), and disability-adjusted life years were analysed. Joinpoint regression was used to quantify long-term trends, while age-period-cohort modelling isolated the effects of demographic factors. Decomposition analysis identified the primary drivers of burden changes. Future trends to 2036 were projected using autoregressive integrated moving average models. Results: In China, caries of deciduous teeth consistently exhibited a higher ASIR than the global average, with a significant increasing trend. Caries of permanent teeth showed a rapidly increasing ASIR, while ASPR remained relatively stable. In contrast, periodontal diseases and edentulism demonstrated modest declines in age-standardized rates, whereas their absolute case numbers and disability-adjusted life years increased substantially, largely driven by population ageing. Other oral disorders showed relatively stable age-standardized rates but continued to contribute a measurable burden. From 2021 to 2036, the ASPR of dental caries in China is expected to increase. Conclusions: China faces a dual oral health challenge, with an unresolved burden of dental caries and an ageing-driven increase in periodontal diseases and edentulism. These findings highlight the need for differentiated prevention and management strategies across age groups, as well as surveillance systems that jointly monitor age-standardized rates and absolute disease burden. Clinical relevance: This study provides an evidence-based foundation for oral health planning in China, supporting strengthened prevention for early childhood caries, improved management of permanent caries, and the integration of periodontal care and tooth loss prevention into routine health services for the ageing population.