Data sources: Medline, Embase and LILACS. Chief Dental Officers worldwide were contacted to request conference reports, theses, government reports and unpublished survey data.
Study selection: Selection was carried out independently by two reviewers. Longitudinal or crossover studies based on random samples representing national, subnational or community populations with SP defined as; a community periodontal index of treatment needs (CPITN) score of four, a clinical attachment loss (AL) more than 6 mm, or a gingival PD more than 5 mm.
Data extraction and synthesis: Data extraction and synthesis followed Global Burden of Disease (GBD) 2010 standards and modeled using a Bayesian meta-regression tool developed for the GBD 2010. Countries were grouped in 21 regions and seven super-regions by geographical proximity and mean age of death.
Results: Seventy two studies involving 291,170 patients were included. The majority of these (65) 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-standardised 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-standardised 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 38 years of age.
Conclusions: Policy makers need to be aware of a predictable increasing burden of SP due to the growing world population associated with an increasing life expectancy 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.