TEHRAN, Iran: A new analysis of Global Burden of Disease data from 2021 shows that, while some indicators of dental caries have improved across the Middle East and North Africa (MENA), the region continues to experience a higher burden of caries than the global average, particularly among adults. The study highlights persistent inequalities, varying national trends and the need for stronger preventive policies.
The study assessed the incidence, prevalence and years lived with disability linked to caries in the primary and permanent dentition across 21 MENA countries from 1990 to 2021. In permanent dentition, the age-standardised incidence rate showed a small upward shift. However, both prevalence and disability rates fell modestly over the same period. Despite these improvements, all three measures remained above global averages, reflecting continued unmet need for prevention and treatment.
For primary teeth, the picture was slightly more positive. Both incidence and prevalence declined region-wide, and disability rates also fell, mirroring global trends. The highest incidence occurred among children aged 5–9, while prevalence peaked in children aged 2–4.
At the national level, variation was pronounced. Afghanistan, Saudi Arabia and Sudan consistently recorded among the highest prevalence rates for caries in the permanent dentition, whereas Iran, Egypt and Morocco reported the lowest. In primary teeth, Saudi Arabia and Iran were among the countries with the highest burden in both 1990 and 2021.
Socio-demographic factors strongly shaped outcomes. The study identified generally higher caries burden in lower-income countries, where limited access to oral healthcare, dental workforce shortages, low insurance coverage and urban–rural service inequalities contribute to poorer oral health. Ongoing conflicts, particularly in Syria, Yemen, Libya and Sudan, have further weakened dental service provision and exacerbated population vulnerability.
Conversely, rising caries incidence in the region’s higher-income countries was linked to increased sugar consumption. The average sugar intake in MENA countries exceeds World Health Organization recommendations, and fewer than half of the countries have implemented taxation on sugar-sweetened beverages.
The authors argue that greater investment in preventive care, early childhood dental programmes and region-wide public health initiatives—particularly those targeting dietary sugar—will be required to reduce the long-term burden. They highlight the need for policies that expand access to affordable dental services and prioritise oral health equity.
The study, titled “Burden of permanent and deciduous dental caries in Middle East and North Africa (MENA): An epidemiological analysis of global burden of disease study from 1990 to 2021”, was published online on 6 October 2025 in BMC Oral Health.
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