Assessing the burden of oral health conditions in the German population: a focus on dental caries, periodontitis, and edentulism.

BACKGROUND

Oral diseases are a major public health problem globally. In Germany, there is a high utilization of dental services, and oral health has significantly improved over the past decades. However, a more specific assessment of burden exerted by oral health conditions, namely carious disease, periodontitis and edentulism is required. In contrast to the Global Burden of Disease (GBD) study which often relies on multiple sources of data to report its estimates, this study uses a nationally representative dataset to provide a focused and detailed assessment of the oral disease burden in Germany.

METHODS

This study analyses nationally representative, cross-sectional oral health data collected by the Institute of German Dentists (IDZ) as part of the Fifth German Oral Health Study (DMS V) study conducted from 2013 to 2014. The data consists of clinical oral health examinations and socio-demographic information for predefined age groups. Prevalence of carious disease, periodontitis, and edentulism was estimated using standardized clinical indices. Disease burden was quantified as Years Lived with Disability (YLDs), applying disability weights and severity distributions from the GBD framework. Estimates were stratified by age and sex, weighted to reflect the German population and compared with corresponding GBD estimates.

RESULTS

The burden of Carious Disease is higher in males than in females. In females aged 35–39 years, the burden of severe carious disease was nearly double that of mild cases, 55.1 YLDs per 100,000 compared to 25.9 YLDs per 100,000, respectively. The prevalence of periodontitis exceeded 97.5% in adults aged 65–69 years, with an approximate burden of 700 YLDs per 100,000 across both sexes. Edentulism affected 47.2% of females aged 85 years and older and had the highest burden of 3162.4 YLDs per 100,000 people.

CONCLUSIONS

This study highlights the marked burden exerted by oral diseases specifically periodontitis and edentulism, especially in older age groups. There are notable sex differences across the oral diseases, and nationally representative DMS V data fills the gaps present in modelled data used be the GBD. Future research can focus on assessing burden estimates for oral conditions under treatment to elucidate differences in treatment strategies and public health decisions.