Catastrophic dental expenditure across age groups and associated factors: results of the 6th German Oral Health Study (DMS • 6).

OBJECTIVES: Although health care services should be accessible, their use should not impose expenditures that put individuals and families at financial risk. This study aimed to identify the prevalence and determinants of catastrophic dental expenditure (CDE) among 12-year-olds, 35- to 44-year-olds, and 65- to 74-year-olds living in Germany. METHOD AND MATERIALS: Using dental expenditure data from the 6th German Oral Health Study (DMS • 6) and annual household cost-of-living information from the German Federal Statistical Office, the extent and determinants of CDE, defined as out-of-pocket spending on dental or orthodontic treatments > 40% of an individual's equivalent capacity to pay over a 1-year period, were examined. Descriptive analyses for sociodemographic variables were performed, and regression analysis was used to clarify the associations of age, gender, type of insurance, geographic region, socioeconomic status (SES), and comorbidities with CDE. RESULTS: The prevalence of CDE among 12-year-olds, 35-to 44-year-olds, and 65- to 74-year-olds in Germany was 0.4% (95% confidence interval [CI], 0.1-1.8%), 0.7% (95% CI, 0.2-1.9%), and 0.4% (95% CI, 0.2-1.2%), respectively. Among the independent variables, only SES and age were significantly associated with CDE (P .05). The risk of CDE was higher in the low-SES group than in the middle- and high-SES groups and higher in older individuals. CONCLUSION: Among all age groups, prevalence of CDE was the highest in the 35-to-44-year-olds. Careful consideration of these findings is warranted to better understand the underlying mechanisms and derive potential policy recommendations. (Quintessence Int 2026;57(Suppl):S134-S141; doi: 10.3290/j.qi.b6955492).