Oral health in migrant population of Germany: a systematic review and meta-analysis

Migrants living in Germany constitute a large and heterogeneous population that is exposed to socioeconomic disadvantages, language barriers and difficulties navigating the health system, all of which may negatively affect oral health and access to dental care. The aim of this study was to systematically review and synthesize available evidence on differences in oral health status and dental service utilization between migrant and non-migrant populations in Germany.

A systematic review of peer-reviewed observational and clinical studies conducted in Germany was performed. Studies meeting predefined inclusion criteria were selected, focusing on oral health indicators such as dental caries prevalence (DMFT scores), periodontal health, and access to preventive dental care. Data on study characteristics, population demographics and outcomes were extracted using a standardized form. Where at least three sufficiently homogeneous studies were available, a meta-analysis of DMFT outcomes was conducted.

Seventeen studies were included in the qualitative synthesis and three in the meta-analysis. Across adult populations, migrants consistently showed worse oral health than non-migrants, with higher DMFT scores (SMD = 0.40; 95% CI: 0.31-0.49; p < 0.05) scores than non-migrants, driven primarily by a higher number of missing teeth (M) (SMD = 0.17; 95% CI: 0.08-0.26; p < 0.05), while differences in decayed (D) and filled (F) teeth were smaller and more heterogeneous. Children and adolescents with a migration background, particularly those living in socioeconomically disadvantaged areas, had higher caries experience and a lower probability of caries-free dentitions in permanent teeth. Evidence on caries in primary dentition (dmft) was limited and heterogeneous and therefore summarized qualitatively only. Across age groups, migrants had lower odds of attending regular preventive dental check-ups than non-migrants (OR approximately 0.64-0.67).

Despite statutory health insurance in Germany, migrants struggle with access to dental services. Structural and social determinants, including socioeconomic position, health literacy, language barriers, and perceived discrimination, likely contribute to these disparities.

Targeted public health strategies, culturally and linguistically adapted information, and measures to improve accessibility of dental care are needed to reduce oral health inequalities between migrants and the native German population.