Global prevalence of edentulism and dental caries in middle-aged and elderly persons: A systematic review and meta-analysis

Objective: The aim of the study was to analyze data collected from studies worldwide on the prevalence of edentulism and dental caries, in community-dwellers aged ≥ 45 years. Data: Inclusion criteria; participants aged ≥ 45 years, community-dwellers. Exclusion criteria; participants aged < 45 years, in nursing homes, data obtained from dental clinics or pre-2005. The quality assessment tool by The National Heart, Lung and Blood Institute for Observational Cohort and Cross-sectional studies was used. Meta-analysis using the random-effects model (95% confidence interval) was done with data on participants who were edentulous and/or had active dental caries and stratified by regions of the world, age and Gross National Income per capita. Limitations in the data arose from several factors such as design of the studies included differences in socioeconomic status and access to health care among different countries. Sources: Embase, MEDLINE via Pubmed and Scopus, manual searches, from January 2016, restricted to English. Experts from different countries were contacted to identify National oral health surveys (NOHS) conducted from 2010 onwards. Study selection: Eighty-six papers and seventeen NOHS were selected for data extraction. Majority of the studies (n = 69) were cross-sectional and of fair quality. 1.1%-70%, 4.9% - 98% prevalence of edentulism and dental caries, respectively. 22%, 45% estimated random-effects pooled prevalence of edentulism and dental caries, respectively. Conclusions: Within the limitations of this study, the findings indicate that untreated dental caries and tooth loss are prevalent on a global level with wide variations among different countries, age groups and socioeconomic status. Clinical significance: The findings demonstrate the reality of the new cohort of older adults, with higher tooth retention implying more dental caries incidence and the need for different care strategies to ensure better oral health. Large variations and difficulty in making comparisons among different countries highlight the need for more standardized, regular research.