Trends and inequalities in age-standardized prevalence rate of edentulism among members of European Union between 1990 and 2021

Edentulism, or the complete loss of teeth, is a major public health concern, particularly among older and economically disadvantaged populations. It affects masticatory function, nutrition, aesthetics, and psychological well-being, and contributes to social isolation and employment difficulties. This study aimed to assess the age-standardized prevalence rates (ASPR) of edentulism in 28 EU member states from 1990 to 2021, focusing on health inequalities across countries and sexes, and identifying trends and peaks in prevalence. Data were obtained from the Global Burden of Disease (GBD) 2021 study. ASPR per 100,000 of edentulism was extracted. Inequalities between countries were evaluated using the Gini Coefficient (GC) and Slope Index of Inequality (SII), while ASPR ratios were calculated to compare countries with the highest and lowest prevalence rates. Total percentage change (TPC) was also extracted and reported. The ASPR of edentulism in the EU was 4986 (95% UI: 3996 to 6041) per 100,000 in 1990 and 4441 (95% UI: 3537 to 5387) per 100,000 in 2021. The TPC for the EU population showed significant variation, with Finland exhibiting decreasing prevalence rate of -27.76 (95% UI: -40.74 to -17.23), and Sweden the increased rate at 31.07 (95% UI: -8.84 to 94.22). ASPR ratios for males in 2021 ranged from 1.00 to 2.33, while females had a narrower range, from 1.00 to 2.07. The highest ASPR ratio was observed in 2010 (4.64), while the lowest was recorded in 2018/2019 (1.84), with notable peaks in 2005 (3.10) and 2020/2021 (2.19). The GC for edentulism declined from 0.121 (95% UI: 0.095 to 0.147) in 1990 to 0.104 (95% UI: 0.079 to 0.129) in 2021, with males consistently exhibiting higher GC values. The SII also decreased from 0.075 (95% UI: 0.060 to 0.090) in 1990 to 0.059 (95% UI: 0.046 to 0.071) in 2021, with the highest SII in 2009 (0.102) and the lowest in 2016 (0.052). Despite a reduction in edentulism prevalence and inequalities by 2021 in some countries, significant inequalities remain between member states of the EU. These findings underscore the need for targeted interventions and policies to address oral health inequalities, particularly for men, who showed higher levels of inequality compared to women.