Burden and forecast of severe periodontitis in BRICS-Plus nations: trends from 1990 to 2040

Severe periodontitis is a global public health challenge, disproportionately affecting low- and middle-income countries. BRICS-Plus nations (35 emerging economies representing > 50% world population) face unique pressures from socioeconomic inequalities and aging populations, yet their epidemiological trends remain understudied. This study aims to quantify the burden of severe periodontitis and project future trends in these nations.

Using data from the Global Burden of Disease Study 2021 (GBD 2021), we analyzed historical trends (1990-2021) of incidence and years lived with disability (YLDs) via the estimated annual percentage change (EAPC). A Bayesian age-period-cohort (BAPC) model was used to generate future projections (2022-2040) that comprehensively account for age, period, and cohort effects.

In 2021, BRICS-Plus contributed 62.52% of global incident cases (89.61 million) and 64.31% of YLDs (6.90 million). Regional disparities were pronounced: Mercosur and SAARC showed the highest age-standardized burdens (incidence: 1132.20/100,000; YLD: 95.52/100,000), while SACU had the lowest (incidence: 600.50/100,000; YLD: 36.78/100,000). Laos exhibited the sharpest historical rises (incidence EAPC = 1.33, 95%CI: 1.02 to 1.65; YLD EAPC = 1.62, 95%CI: 1.18 to 2.06). BAPC projections indicate sustained growth in Laos, with 40-60-year-olds remaining as the high-risk group, while over half of BRICS-Plus nations may experience downward trends by 2040.

Severe periodontitis exhibits divergent trends across BRICS-Plus, with Laos facing escalating burden while most nations show projected declines. Implementing targeted interventions-including tailored dental healthcare strengthening in high-prevalence regions and evidence-based preventive strategies targeting vulnerable middle-aged demographics-is essential for effectively addressing these divergent trends and reducing the overall disease burden.