Abstract
ObjectiveThis is the second part of a report on tooth loss in Germany 1997–2030. Here, we describe trends in the prevalence of edentulism in seniors 1997–2014, assess predictive factors for edentulism, and projected it into 2030.Material and methodsWe used data from three waves of the cross-sectional, multi-center, nationwide representative German Oral Health Studies. Overall, 3449 seniors (65–74 years) were included (1997: 1367; 2005: 1040; 2016: 1042). Age, sex, educational level, smoking status, and the cohort were entered into age-cohort binary-logistic regression models to assess the association of predictors with edentulism and to project edentulism in 2030 via Monte Carlo simulations.ResultsBetween 1997 and 2014, the prevalence of edentulism decreased from 24.8 to 12.4%. With each year of age, the risk of being edentate increased (by 11%, p < 0.001); it was also significantly increased in female versus male (by 40%, p = 0.001), low versus medium and high educational level (up to 257%, p < 0.001), and in former and current smokers (up to 258%, p < 0.001). We predict the prevalence of edentulism to be reduced to 4.2% in 2030. The reduction will be higher in males, never and former smokers, and those with low socio-educational level. On an absolute level and despite a growing elderly population (aged 60–80 years), the number of edentate individuals will have decreased by 3.6 million in 2030 compared with 1997.ConclusionsEdentulism in seniors has declined equitably in Germany. The decline is expected to continue until 2030. Further efforts are needed to tackle the underlying risk factors.Clinical relevanceThis study presents trends of edentulism in Germany for a period of three decades. It provides clinically relevant data for health care planning by 2030.
Highlights
Tooth loss is the final outcome of dental diseases like caries and periodontitis, developing through complex pathways overBetween 1990 and 2010, the global prevalence of edentulism decreased from 4.4 to 2.4% after age standardization [5], following longer-term trends observed in many industrialized countries like the USA, where edentulism prevalence declined from 19% in the 1950s to 5% in the late 2000s
When evaluating edentulism in different dental arches, it became obvious that edentulism was a more frequent phenomenon in the upper than the lower arch regardless of the period of assessment, and that the relative reduction was similar in the upper arch (1997/2005/2014; mean: 45.4 (42.8–48.1)/32.1 (29.2–34.9)/18.8 (16.4–21.2)%; mean reduction 1997–2014: − 59%) and the lower arch (29.2 (26.8–31.6)/23.8 (21.2–26.4)/12.3 (10.3–14.3)%; − 58%)
When entering the predictors into the model, all parameters were significantly associated with edentulism prevalence (Table 2)
Summary
Between 1990 and 2010, the global prevalence of edentulism decreased from 4.4 to 2.4% after age standardization [5], following longer-term trends observed in many industrialized countries like the USA, where edentulism prevalence declined from 19% in the 1950s to 5% in the late 2000s. Notable, this decline was not distributed between populations, with high-income households experiencing a greater relative decline than low-income households (the absolute decline, was smaller). We aimed to describe trends in the prevalence of edentulism in seniors 1997–2014, to assess predictive factors for edentulism, and to project edentulism into 2030
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