Inequalities in prevalence rate of edentulism in the European Union between 1990 and 2019

Abstract

Abstract Background Edentulism, characterized by tooth loss, serves as a global indicator of oral health burden, particularly affecting older and economically disadvantaged populations. We aimed to assess health inequalities in age-standardized prevalence rate (ASPR) of edentulism across 28 EU member states and EU as a whole between 1990 and 2019. Methods We retrieved ASPR, annual rate of change (ARC) and 95% uncertainty interval from the Global Burden of Disease (GBD) 2019 study. We calculated the ASPR ratio between 1990 and 2019 and country-paired ASPR for 2019. To estimate the inequalities between countries between 1990 and 2019, we used the Gini Coefficient (GC) and Slope Index of Inequality (SII). Results The EU ASPR for edentulism was 5912 (95% UI: 4751-7473) in 1990 while in 2019 it was 5048 (95% UI: 3970-6485). Sweden had the lowest ASPR in 1990, while Spain held this position in 2019. The highest rates in 1990 were observed in Poland and the Netherlands, with the Netherlands maintaining the highest ASPR in 2019. Spain exhibited the lowest ARC at -0.325 (95% UI: -0.477--0.193), while Sweden was the sole country with a positive value, at 0.034 (95% UI: -0.009-0.075). The ASPR ratio across all EU member states exhibited a range of values for males, from 1.00-2.16, and for females, from 1.00 to 1.87. The ASPR ratios ranged between 1.81 and 2.16 from 1990 to 2000. The GC was 0.097 (95% UI: 0.076-0.117) in 1990 and subsequently decreased-0.084 (95% UI: 0.063-0.105) by 2019. The SII exhibited a range from 0.062 (95% UI: 0.051-0.072) in 1990-0.046 (95% UI: 0.038-0.054) in 2019. Conclusions Inequalities in edentulism in the EU were similarly low when comparing 1990 and 2019. However, there was an alarming increase in inequalities between 2005 and 2010. This underscores the need for targeted interventions and policy measures-address oral health inequalities, considering socio-economic factors, healthcare policies, sex disparities, and public awareness initiatives. Key messages • Edentulism is a significant public health concern within the EU for approximately 30 years. • It has demonstrated comparable disparities in prevalence at both the beginning and end of the period, with a noticeable intensification in the interim.