National oral health survey on refugees in Germany 2016/2017: caries and subsequent complications
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ORIGINAL ARTICLE
National oral health survey on refugees in Germany 2016/2017: caries and subsequent complications A. Al-Ani 1 & M. Takriti 1 & J. Schmoeckel 1 & M. Alkilzy 1 & C. H. Splieth 1 Received: 26 July 2019 / Accepted: 1 September 2020 # The Author(s) 2020
Abstract Objectives To assess oral health, caries prevalence, and subsequent complications among recently arrived refugees in Germany and to compare these findings with the German resident population. Methods This multicenter cross-sectional study recruited 544 refugees aged 3–75+ years; they were examined at ten registration institutions in four federal states in Germany by two calibrated dentists. The refugees were screened for caries (dmft/DMFT) and its complications (pufa/PUFA); this data was compared to the resident population via the representative national oral health surveys). Results The deciduous dentition of the 3-year-old refugees had a mean dmft value of 2.62 ± 3.6 compared with 0.48 dmft in the German resident population, and caries increased to 5.22 ± 3.4 for 6–7-year-olds (Germany: 1.73 dmft). Few refugee children had naturally healthy teeth (7% in 6–7-year-olds, Germany: 56%). In the permanent dentition, the gap in caries prevalence between refugees and the German population decreased with age (35–44-year-olds: 10.55 ± 7.1 DMFT; Germany: 11.2), but refugees exhibited more caries defects (35–44-year-olds DT = 3.13 ± 3.0; Germany: 0.5). German residents had more restorations (35–44year-olds FT = 4.21 ± 4.6). Regarding complications, the 6–7-year-olds exhibited the highest pufa index (0.86 ± 1.4) which decreased in adolescence (13–17-year-olds, 0.18 ± 0.6) and increased in adults (45–64-year-olds, 0.45 ± 0.8). Conclusion The refugees had high caries experience, often untreated caries teeth and more complications compared with the German resident population, especially in children. Closing this gap by extending preventive systems to the refugees would decrease future treatment needs. Clinical relevance European countries should be prepared for the higher dental treatment needs in recent refugees, especially in children. Keywords Oral health . Refugees . Germany . Caries . Decayed . Missing and filled teeth index . Resident
Introduction The United Nations High Commissioner for Refugees counts 25.4 million refugees in its statistics, with numbers rising significantly in recent years as a result of the wars in Syria, Afghanistan, Iraq, Ukraine, Yemen, and many other countries worldwide [1]. Trying to reach a safe country, Canada, Australia, USA, Lebanon, Turkey, and many other countries are their destinations. Recently, Europe and especially Germany were affected by refugees in 2015/2016 according to the International Organization for Migration [2]. It was esti-
* C. H. Splieth [email protected] 1
Department of Preventive and Pediatric Dentistry, University of Greifswald, Fleischmannstr. 42, 17475 Greifswald, Germany
mated that far more than one million refugees have arrived in the country, provisionally counted in the “EASY” syst
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