Trend analysis and projection of periodontitis disease burden based on an age-period-cohort model

DU Changhan; GAO Linxi; ZHAO Weijuan; LUO Jinghua; LU Xinyu; LI Ling

doi:10.15956/j.cnki.chin.j.conserv.dent.2026.01.002

Abstract：Objective Analyze the trend of dental periodontal disease burden in China and the influence of age,period,and birth cohort factors,and predict its future trend,in order to provide a reference for the prevention and control of dental periodontal disease.Methods Based on the GBD 2023 database,the data on the incidence of periodontal disease and Disability-Adjusted Life Years(DALY)in China from 1990 to 2023 were obtained.Joinpoint regression models were employed to evaluate temporal trends,calculating the average annual percentage change(AAPC).An age-period-cohort model was used to assess the effects of age,period,and birth cohort on incidence and DALY rates.A Bayesian age-period-cohort model was applied to project age-standardized incidence rates(ASIR)and age-standardized DALY rates(ASDR)for 2024-2033.Results From 1990 to 2023,China exhibited increasing trends in periodontal disease ASIR(AAPC=0.31%,95%CI:0.10-0.53)and age-standardized DALY rates(AAPC=0.47%,95%CI:0.14-0.80).The APC model revealed:Age effect—Peak incidence occurred at 50-54 years(2 089.83 per 100 000),while peak DALY rate was observed at 60-64 years(213.03 per 100 000).Period effect—The highest risk for incidence(RR=1.06,95%CI:1.02-1.11)and DALY(RR=1.12,95%CI:1.08-1.15)occurred during 2014-2018.Cohort effect—Disease burden increased with successive birth cohorts,peaking in the 2012-2016 cohort(incidence RR=2.16,95%CI:0.37-12.56;DALY RR=2.30,95%CI:0.13-13.39).It is predicted that the age-standardized incidence rate of periodontal disease(1 101.62 per 100 000 in 2033)and the age-standardized DALY rate(77.12 per 100 000 in 2033)will show an upward trend from 2024 to 2033.Conclusion From 1990 to 2023,the burden of periodontal disease in China has been on the rise.It is predicted that it will continue to increase from 2024 to 2033,and the middle-aged and elderly population should pay particular attention to it.