Rising Burden of Oral Disorders: The Impact of Social and Commercial Determinants on the Unequal Increase of Disease Burdens Across Global, Regional and National Contexts

Background In 2020, the World Federation Dental highlighted the importance of oral health in "Vision 2030," noting the widespread impact of oral disorders, which affected 3.5 billion people in 2019. Despite their prevalence, these disorders are often overlooked in healthcare due to their non-life-threatening nature. This study evaluates the global, regional, and national burden of oral disorders from 1990 to 2021, providing insights for future oral health policies and addressing inequalities. Methods We analyzed data from the GBD 2021 database, examining incidence, prevalence, and DALYs of oral disorders from 1990 to 2021. We calculated age-standardized rates, Estimated Annual Percentage Change (EAPC), and percentage changes across super-regions, genders, SDI groupings, and 204 countries or territories. The Age-Period-Cohort model explored temporal burden differences, while the Geographically Weighted Regression model assessed the impact of social and commercial health determinants on ASIR. Results In 2021, global DALYs due to oral disorders reached 23.24 million, with 3.7 billion prevalent cases. The global ASDR and ASPR showed slight decreases, but ASIR increased. Sub-Saharan Africa experienced significant rises in DALYs, incidence, and prevalence. Edentulism accounted for 41.3% of DALYs worldwide. Middle SDI countries showed a rapid increase in disease burden, with children most affected. Social and commercial health determinants, notably smoking and sugar intake, considerably impacted LMICs more than HICs. Conclusion Oral disorders affect approximately 3.7 billion people globally, with LMICs experiencing doubled burdens. Vulnerable groups include children and the elderly, exacerbated by socio-economic disparities and commercial determinants. LMICs must enhance dental resources, integrate oral care into primary healthcare, and counteract commercial influences to ensure optimal oral health.