Periodontal Disease and Edentulism Trends in Older Women of China and Association of Southeast Asian Nations, 1990 to 2033

AIMS: To assess trends, co-occurrence patterns, and future projections of periodontal disease and edentulism burden among women aged ≥60 years in China and Association of Southeast Asian Nations (ASEAN) countries from 1990 to 2033. METHODS: Using Global Burden of Disease 2023 data, we analysed age-standardized disability-adjusted life years (DALYs) for both conditions in China and 10 ASEAN countries. Quartile-based co-occurrence classification, frontier analysis against the Sociodemographic Index, and ARIMA models (2024-2033) were applied. RESULTS: In 2023, periodontal disease DALY rates were highest in Thailand (183.93 per 100,000) and Indonesia (183.77); edentulism rates peaked in the Philippines (948.96) and Malaysia (811.45). From 1990 to 2023, edentulism declined across most countries (ASEAN aggregate: 709.39-641.96), while periodontal disease increased in Indonesia and Thailand. Frontier analysis showed edentulism burden plateaus at higher Sociodemographic Index levels. ARIMA projections indicate continued edentulism decline through 2033 (ASEAN: 636-586) but rising periodontal disease burden in China and Indonesia. CONCLUSION: The burden is shifting from tooth loss to chronic periodontal inflammation among aging women in China and ASEAN. Country-specific strategies prioritizing periodontal screening and integrated oral primary care are needed. CLINICAL RELEVANCE: These findings inform targeted oral health policies for older women, emphasizing the need to shift from tooth preservation alone to active periodontal management. Specifically, countries with rising periodontal burden should prioritize screening and non‑surgical therapy, while those with persistent high edentulism need expanded restorative and preventive coverage-particularly in rapidly developing regions where tooth retention is increasing but maintenance lags behind.