The Fifth German Oral Health Study (Fünfte Deutsche Mundgesundheitsstudie, DMS V) - rationale, design, and methods

Rainer A Jordan, Constanze Bodechtel, Katrin Hertrampf, Thomas Hoffmann, Thomas Kocher, Ina Nitschke, Ulrich Schiffner, Helmut Stark, Stefan Zimmer, Wolfgang Micheelis, DMS V Surveillance Investigators’ Group, Rainer A Jordan, Wolfgang Micheelis, Inge Bayer, Constanze Bodechtel, Ursula Reis, Linda Scharf, Rainer A Jordan, Katrin Hertrampf, Thomas Hoffmann, Thomas Kocher, Wolfgang Micheelis, Ina Nitschke, Ulrich Schiffner, Helmut Stark, Sarah Noffz, Birte Holtfreter, Thomas Bachmann, Jörg Eschenlohr, Thomas Rappold, Elisabeth Füßl-Grünig, Elisabeth Füßl-Grünig, Constanze Bodechtel, Dieter Baumert, Peter Brietsche, Markus Nispel, Joachim Schulze, Gülay Aykal, Beate Bohnke-Schulz, Regine Dirbach, Martin Engler, Jutta Gesk, Bernd Habersaat, Rita Schleypen, Kerstin Groß, Nele Kettler, Johannes Löw, Nikola Johanna Sprehe, Detlef Joachim Weimar, Rainer A Jordan, Constanze Bodechtel, Katrin Hertrampf, Thomas Hoffmann, Thomas Kocher, Ina Nitschke, Ulrich Schiffner, Helmut Stark, Stefan Zimmer, Wolfgang Micheelis, DMS V Surveillance Investigators’ Group, Rainer A Jordan, Wolfgang Micheelis, Inge Bayer, Constanze Bodechtel, Ursula Reis, Linda Scharf, Rainer A Jordan, Katrin Hertrampf, Thomas Hoffmann, Thomas Kocher, Wolfgang Micheelis, Ina Nitschke, Ulrich Schiffner, Helmut Stark, Sarah Noffz, Birte Holtfreter, Thomas Bachmann, Jörg Eschenlohr, Thomas Rappold, Elisabeth Füßl-Grünig, Elisabeth Füßl-Grünig, Constanze Bodechtel, Dieter Baumert, Peter Brietsche, Markus Nispel, Joachim Schulze, Gülay Aykal, Beate Bohnke-Schulz, Regine Dirbach, Martin Engler, Jutta Gesk, Bernd Habersaat, Rita Schleypen, Kerstin Groß, Nele Kettler, Johannes Löw, Nikola Johanna Sprehe, Detlef Joachim Weimar

Abstract

Background: Oral diseases rank among the most prevalent non-communicable diseases in modern societies. In Germany, oral epidemiological data show that both dental caries and periodontal diseases are highly prevalent, though significant improvements in oral health has been taking in the population within the last decades, particularly in children. It is, therefore, the aim of the Fifth German Oral Health Study (DMS V) to actualize the data on current oral health status and to gather information on oral health behavior and risk factors. In addition to current oral health monitoring, the study will also permit conclusions about trends in the development of oral health in Germany between 1989 and 2014.

Methods/design: DMS V is a cross-sectional, multi-center, nationwide representative, socio-epidemiological study to investigate the oral health status und behavior of the German resident population in four age cohorts. Study participants are children (12-year-olds), adults (35- to 44-year-olds), young olds (65- to 74-year-olds), and old olds (75- to 100-year-olds) who are drawn from local residents' registration offices. Social-science investigation parameters concern subjective perceptions and attitudes regarding oral health and nutrition, sense of coherence, and socio-demographic data. Clinical oral parameters are tooth loss, caries and periodontitis, prosthodontic status, further developmental and acquired dental hard tissue and mucosal lesions. To ensure reproducibility, the dental investigators are trained and calibrated by experts and multiple reliability checks are performed throughout the field phase. Statistical analyses are calculated according to a detailed statistical analysis plan.

Discussion: The DMS studies first performed in 1989, 1992 and repeated in 1997 and 2005 are the only cross-sectional oral health studies conducted in Germany on a population-based national representative level. Updated prevalence and trend analyses of key oral diseases are, therefore, of major epidemiological and health services research interest.

Trial registration: German Health Services Research Data Bank VfD_DMSV_13_002152.

Figures

Figure 1
Figure 1
DMS V study sample points*. *Orange marked communities or cities are regular study sample points; in red marked cities, more than 1 study sample point was selected; in yellow marked study sample points, the communities were too small by population to achieve the target number of study participants and a so called synthetic study sample point was built by pooling several surrounding communities.

References

    1. König J, Holtfreter B, Kocher T. Periodontal health in Europe: future trends based on treatment needs and the provision of periodontal services–position paper 1. Eur J Dent Educ. 2010;14(Suppl 1):4–24. doi: 10.1111/j.1600-0579.2010.00620.x.
    1. Petersen PE. Improvement of global oral health–the leadership role of the World Health Organization. Community Dent Health. 2010;27(4):194–198.
    1. Micheelis W, Bauch J. Oral health of representative samples of Germans examined in 1989 and 1992. Community Dent Oral Epidemiol. 1996;24(1):62–67. doi: 10.1111/j.1600-0528.1996.tb00815.x.
    1. Schiffner U, Hoffmann T, Kerschbaum T, Micheelis W. Oral health in German children, adolescents, adults and senior citizens in 2005. Community Dent Health. 2009;26(1):18–22.
    1. Schutzhold S, Holtfreter B, Hoffmann T, Kocher T, Micheelis W. Trends in dental health of 35- to 44-year-olds in West and East Germany after reunification. J Public Health Dent. 2013;73(1):65–73. doi: 10.1111/jphd.12007.
    1. WHO, World Health Organization . Oral Health,Country/Area Profile Programme (CAPP). Caries for 12-Year-Olds by Country/Area. Malmö: Malmö University; 2014.
    1. Dünninger P, Uhl T, Einwag J, Naujoks R. Die Veränderung der Mundgesundheit in der Bundesrepublik Deutschland - das Projekt A10. Dtsch Zahnarztl Z. 1995;50(1):40–44.
    1. Busse H, Geiger L. Kariesprävalenz bei Kindern und Jugendlichen in der ehemaligen DDR. Bundesgesundheitsbl. 1990;33(12):538.
    1. Holtfreter B, Berg MH, Kocher T, Schiffner U, Hoffmann T, Micheelis W. Change in FS-T index in adults in the German national oral health surveys between 1989 and 2005. Community Dent Oral Epidemiol. 2013;41(3):251–260. doi: 10.1111/j.1600-0528.2012.00739.x.
    1. Zhan Y, Holtfreter B, Meisel P, Hoffmann T, Micheelis W, Dietrich T, Kocher T. Prediction of periodontal disease: modelling and validation in different general German populations. J Clin Periodontol. 2014;41(3):224–231. doi: 10.1111/jcpe.12208.
    1. IDZ, Institut der Deutschen Zahnärzte . Zur Mundgesundheit von Pflegebedürftigen und Menschen mit Behinderungen in Deutschland - eine systematische Übersicht (Review) auf der Grundlage aktueller Einzelstudien (2000-2012) Köln: IDZ Informationsdienst; 2012.
    1. IDZ, Institut der Deutschen Zahnärzte . Mundgesundheitszustand und -verhalten in der Bundesrepublik Deutschland. Köln: Deutscher Ärzte-Verlag; 1991.
    1. IDZ, Institut der Deutschen Zahnärzte . Mundgesundheitszustand und -verhalten in Ostdeutschland. Köln: Deutscher Ärzte-Verlag; 1993.
    1. IDZ, Institut der Deutschen Zahnärzte . Dritte Deutsche Mundgesundheitsstudie (DMS III) Köln: Deutscher Ärzte-Verlag; 1999.
    1. IDZ, Institut der Deutschen Zahnärzte . Vierte Deutsche Mundgesundheitsstudie (DMS IV) Köln: Deutscher Zahnärzte Verlag; 2006.
    1. Chan AW, Tetzlaff JM, Altman DG, Laupacis A, Gotzsche PC, Krleza-Jeric K, Hrobjartsson A, Mann H, Dickersin K, Berlin JA, Dore CJ, Parulekar WR, Summerskill WS, Groves T, Schulz KF, Sox HC, Rockhold FVV, Rennie D, Moher D. SPIRIT 2013 statement: defining standard protocol items for clinical trials. Ann Intern Med. 2013;158(3):200–207. doi: 10.7326/0003-4819-158-3-201302050-00583.
    1. (BfArM) Bundesinstitut für Arzneimittel und Medizinprodukte Anforderungen an die Hygiene bei der Aufbereitung von Medizinprodukten. Empfehlung der Kommission fur Krankenhaushygiene und Infektionspravention (KRINKO) beim Robert Koch-Institut (RKI) und des Bundesinstitutes fur Arzneimittel und Medizinprodukte (BfArM) Bundesgesundheitsbl. 2012;55(10):1244–1310. doi: 10.1007/s00103-012-1548-6.
    1. Franke A. Salutogenese. Zur Entmystifizierung der Gesundheit. Tübingen: dgvt; 1997.
    1. WHO, World Health Organization Guide to epidemiology and diagnosis of oral mucosal diseases and conditions. Community Dent Oral Epidemiol. 1980;8(1):1–26. doi: 10.1111/j.1600-0528.1980.tb01249.x.
    1. Ramanathan J, Leclercq MH, Mendis BR, Barmes DE. Gathering data on oral mucosal diseases: a new approach. World Health Forum. 1995;16(3):299–304.
    1. Roed-Petersen B, Renstrup G. A topographical classification of the oral mucosa suitable for electronic data processing. Its application to 560 leukoplakias. Acta Odontol Scand. 1969;27(6):681–695. doi: 10.3109/00016356909026317.
    1. Weerheijm KL, Duggal M, Mejare I, Papagiannoulis L, Koch G, Martens LC, Hallonsten AL. Judgement criteria for molar incisor hypomineralisation (MIH) in epidemiologic studies: a summary of the European meeting on MIH held in Athens, 2003. Eur J Paediatr Dent. 2003;4(3):110–113.
    1. Bartlett D, Ganss C, Lussi A. Basic Erosive Wear Examination (BEWE): a new scoring system for scientific and clinical needs. Clin Oral Investig. 2008;12(Suppl 1):S65–S68. doi: 10.1007/s00784-007-0181-5.
    1. Klein H, Palmer CE, Knutson JW. Studies on dental caries. I. Dental status and dental needs of Elementary School Children. Public Health Rep. 1938;53(19):751–765. doi: 10.2307/4582532.
    1. WHO, World Health Organization . Oral health surveys: Basic methods. 5 2013.
    1. Katz RV. Assessing root caries in populations: the evolution of the root caries index. J Public Health Dent. 1980;40(1):7–16. doi: 10.1111/j.1752-7325.1980.tb01844.x.
    1. Albandar JM. Underestimation of periodontitis in NHANES surveys. J Periodontol. 2011;82(3):337–341. doi: 10.1902/jop.2011.100638.
    1. Ramfjord SP. Indices for prevalence and incidence of periodontal disease. J Periodontol. 1959;30(1):51–59.
    1. Holmgren CJ, Corbet EF. Relationship between periodontal parameters and CPITN scores. Community Dent Oral Epidemiol. 1990;18(6):322–323. doi: 10.1111/j.1600-0528.1990.tb00090.x.
    1. Clerehugh V, Lennon MA. The attachment level as a measure of early periodontitis. Community Dent Health. 1984;1(1):33–40.
    1. Saxer UP, Mühlemann HR. Motivation und Aufklärung. Schweiz Monatsschr Zahnmed. 1975;85:905–920.
    1. Nitschke I. Zur Mundgesundheit von Senioren. Ein epidemiologischer Überblick über ausgewählte orofaziale Erkrankungen und ihre longitudinale Betrachtung. Berlin: Quintessenz; 2006.
    1. DGEpi, German Society for Epidemiology . Guidelines and Recommendations to Assure Good Epidemiologic Practice (GEP). Long Version. Hannover: DGEpi, Deutsche Gesellschaft für Epidemiologie; 2008.
    1. Holtfreter B, Kocher T, Hoffmann T, Desvarieux M, Micheelis W. Prevalence of periodontal disease and treatment demands based on a German dental survey (DMS IV) J Clin Periodontol. 2010;37(3):211–219. doi: 10.1111/j.1600-051X.2009.01517.x.
    1. Ekman A. Chapter 5.10: major public health problems - dental health. Scand J Public Health Suppl. 2006;67:139–146. doi: 10.1080/14034950600677170.
    1. Mossey P, Shaw B. Tribute to David E. Barmes. Br Dent J. 2001;191(6):287.
    1. Hobdell MH, Oliveira ER, Bautista R, Myburgh NG, Lalloo R, Narendran S, Johnson NW. Oral diseases and socio-economic status (SES) Br Dent J. 2003;194(2):91–96. doi: 10.1038/sj.bdj.4809882.
    1. Ziller S, Micheelis W, Oesterreich D, Reich E. Goals for oral health in Germany 2020. Int Dent J. 2006;56(1):29–32.
Pre-publication history
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Source: PubMed

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