6th German Oral Health Study (DMS • 6): research design, data collection, and statistical methods of the longitudinal...

Since 1989, the German Oral Health Studies (DMS) have collected nationally representative socio-epidemiologic data on oral health in Germany. For the first time, the 6th study in this series (DMS • 6) was designed as a combined cross-sectional and cohort study. The DMS • 6 cohort comprised participants from the preceding study (DMS V) who were reexamined after approximately 9 years. The primary aims of this longitudinal component of DMS • 6 were to analyze incident diseases and individual disease trajectories across the observation period and to identify antecedent risk factors.

All DMS V participants from the target population served as the sampling base for the follow-up examination in the DMS • 6 cohort (baseline; n = 3,476). After excluding individuals who declined consent to participate or were lost to follow-up or quality-neutral and systematic attrition, the final sample for the DMS • 6 cohort comprised 1,089 participants, with a retention rate of 31.3%. These participants were reassessed approximately 9 years after the baseline examination and were categorized into three age groups: adolescents (12-year-olds at baseline; 20-year-olds at follow-up), adults (35- to 44-year-olds at baseline; 43- to 52-year-olds at follow-up), and seniors (65- to 74-year-olds at baseline; 73- to 82-year-olds at follow-up).

Baseline data were collected from October 2013 to June 2014. The mean interval between baseline and follow-up was 9.1 (± 0.3) years. Fieldwork and data collection for the follow-up were conducted from October 2022 to September 2023. In both study waves, data on oral health, oral-health behaviors, and sociopsychological characteristics were obtained through clinical examinations and social-science surveys conducted at temporarily established study centers. Data processing and statistical analyses: Longitudinal statistical analyses comprised an epidemiologic description of changes in disease patterns over time based on a dataset weighted using calibrated attrition weights. The prevalence, distribution, and means of the relevant characteristics at baseline and follow-up were compared. Subsequently, the incidence (new onset) and progression (worsening) of each condition of interest were estimated. Cumulative incidence/progression and incidence/progression rates were reported. To quantify the magnitude of change, the mean difference between baseline and follow-up measurements and the annual rate of change were calculated. In addition, longitudinal association analyses were performed to evaluate the influence of participant characteristics on the changes in oral diseases. (Quintessence Int 2026;57 (Suppl):S4-S13; doi: 10.3290/j.qi.b6955464).