Abstract
BACKGROUND: Edentulism, the complete loss of natural teeth, remains a major public health issue worldwide, particularly affecting women and older adults. This study aims to evaluate the disease burden of edentulism among women in China, the United States, and globally, addressing the gap that few prior studies have conducted sex-specific comparative analyses of edentulism to inform policy-making and resource allocation for women's oral health. METHODS: This retrospective, population-based study used data from the Global Burden of Disease (GBD) 2021, a worldwide program that evaluates and compares health outcomes-including mortality and disability-across diseases and populations. We analyzed the incidence and Years Lived with Disability (YLD) of edentulism among women in China, the United States, and globally from 2002 to 2021. Age-standardized rates (ASR), Estimated Annual Percentage Change (EAPC), and Bayesian Age-Period-Cohort (APC) models were applied to assess temporal effects and predict trends to 2046. RESULTS: China's age-standardized incidence rate (ASIR) remained consistently below the global average ASIR derived from the GBD 2021 dataset, with a brief period (2006-2012) where it exceeded that of the United States. Age-specific analysis revealed that edentulism incidence increased most prominently among younger women in China (20-29 years) and older women in the United States (65-84 years). The APC analysis revealed that edentulism in China peaked around age 75, while in the United States, it peaked at age 65. Predictions indicate that ASIR in both countries will continue to rise from 2022 to 2046. CONCLUSION: The study highlights a concerning upward trend in the burden of edentulism, particularly among young women in China and elderly women in United States. Predictions suggest a sustained increase in incidence rates in these regions, underscoring the need for stronger healthcare policies and resource allocation toward preventive and rehabilitative dental care for women.