Incidence and progression of caries experience in Germany: results of the 6th German Oral Health Study (DMS • 6).

OBJECTIVES: Longitudinal evidence on individual-level changes in caries experience across the life course in Germany is lacking. Therefore, one objective of the 6th German Oral Health Study (DMS • 6) was to reexamine participants of the Fifth German Oral Health Study (DMS V) after 9 years, to assess changes in the caries burden during the life course. METHOD AND MATERIALS: The caries experience, including decayed, missing, filled teeth (DMFT), and root caries, was assessed at baseline (2014) and follow-up (2023) in three age groups of the DMS • 6 cohort. The sample comprised 371 adolescents (20-year-olds at follow-up), 342 adults (43- to 52-year-olds at follow-up), and 350 seniors (73- to 82-year-olds at follow-up). Mean changes in caries experience and participant-level caries incidence and progression were calculated. RESULTS: Mean DMFT increased from 0.4 to 1.8 in adolescents, from 10.7 to 11.8 in adults, and from 16.1 to 18.5 in seniors. Furthermore, the proportion of caries-free adolescents reduced from 81.7% to 47.7%. The cumulative caries incidence in adolescents who were caries-free at baseline was 43.2%. Cumulative caries progression (at least one additional DMF tooth) was observed in 54.1%, 58.4%, and 77.0% of adolescents, adults, and seniors, respectively. Regarding the tooth surface level, 98.3%, 91.1%, and 77.5% of tooth surfaces remained sound throughout the observation period in adolescents, adults, and seniors, respectively. The prevalence of root caries markedly increased from 11.1% to 30.7% in adults and from 32.9% to 61.1% in seniors. CONCLUSION: This 9-year longitudinal study demonstrated caries increments during the life course in all three age groups. Adolescents predominantly presented with newly filled teeth, adults showed increased numbers of filled and missing teeth, and seniors primarily presented with a larger number of extracted teeth. Individuals with early caries experience exhibited greater increments. The pronounced increase in root caries among adults and seniors highlights the need to intensify targeted root-surface-focused prevention alongside ongoing primary prevention for high-risk groups. (Quintessence Int 2026;57(Suppl):S14-S22; doi: 10.3290/j.qi.b6955475).