Incidence and progression of periodontitis and tooth loss between 2014 and 2023 in Germany: results of the 6th German Oral Health Study (DMS • 6).

OBJECTIVES: Examining periodontitis progression and tooth loss (TL) on a national level is necessary to identify risk and protective factors as well as to improve the implementation of future interventions. This longitudinal study evaluated periodontitis incidence and progression using changes in probing depth (PD) and TL between 2014 and 2023. In addition, the risk factors associated with periodontitis progression were evaluated. METHOD AND MATERIALS: The sample included 340 adults and 313 seniors from the DMS • 6 cohort who were first examined in 2014 (baseline) and reexamined in 2023 (follow-up). To maintain consistency between the baseline and follow-up measurements, only partial-mouth PD recordings (12 index teeth, three sites each) were included. Exposure variables were assessed using a questionnaire. Outcome variables included mean PD, Community Periodontal Index (CPI), and TL. Associations were examined using generalized linear regression models. RESULTS: The prevalence of CPI score 4 increased from 10.5% to 22.9% in adults and from 22.0% to 29.6% in seniors. During follow-up, the mean TL in adults and seniors was 0.6 ± 1.2 and 1.9 ± 2.8 teeth, respectively, corresponding to an annual TL rate of 0.1 to 0.2 teeth. Higher school education was associated with a lower risk for TL, whereas smoking and diabetes increased the risk for TL. The use of electric toothbrushes was associated with a lower risk of TL, whereas professional tooth cleaning showed no significant effect. CONCLUSION: Improvements in oral hygiene practices over the past few decades are not sufficient for preventing periodontitis progression and TL in aging populations. (Quintessence Int 2026;57(Suppl): S34-S44; doi: 10.3290/j.qi.b6955516).