More teeth in more elderly: Periodontal treatment needs in Germany 1997-2030

Objective With more teeth retained for longer in an ageing population, population-wide periodontal treatment needs may increase. We assessed and projected periodontal treatment needs from 1997 to 2030 in Germany. Methods Partial-mouth probing-pocket depths (PPDs) from repeated waves (1997, 2005, 2014) of the nationally representative German Oral Health Studies were transformed into full-mouth PPDs via decision-tree-based ensemble-modelling. In line with German healthcare-regulations, teeth with PPD >= 4 mm were regarded as needing periodontal treatment. Weighted means were interpolated cross-sectionally by fitting spline-curves and then regressed longitudinally 1997-2030. Results In 1997, younger adults (35-44 years old) had a mean of 7.4 teeth needing treatment (overall 93.8 million teeth); this decreased to 4.8 teeth (47.3 million teeth) in 2014. For 2030, we project 3.2 teeth (33.7 million teeth). In seniors, an increase was recorded (1997: 4.5 teeth, 33.5 million teeth; 2014: 7.5 teeth, 63.4 million teeth); this is expected to continue until 2030 (to 12.2 teeth, 140.8 million teeth). The cumulative number of teeth needing treatment increased from 2000 (355 million) to 2015 (365 million), and will increase further to 2030 (464 million). Conclusions Population-wide periodontal treatment needs may increase until 2030, mainly in the elderly. Concepts for addressing, these growing needs are required.