Hat die zahnärztliche Früherkennungs-untersuchung Einfluss auf die Zahn- gesundheit von 6- bis 7-jährigen Kindern in Deutschland?

Introduction: The aim of this study was to investigate whether the use of early dental screenings (FU; using the version from 1999), to which legally insured children aged 3-5 years are entitled in Germany, correlates with the caries status of these children at the age of 6-7 years.

Methods: The study is based on a retrospective analysis of data from various publicly available sources: the population statistics of the Federal Republic of Germany (for the number of eligible children), the billing data from the National Association of Statutory Health Insurance Dentists (KZBV) on the use of FU and their financing via statutory health insurance (GKV) as well as the data from the German Association for Youth Dental Care (DAJ) on caries prevalence (dmft [decayed, missing, filled tooth] index according to the World Health Organization [WHO] standard). We linked the dental health in the form of the caries values (dmft) collected by the DAJ for 6-7-year-olds in 2009 and 2016 with the FU billed for these children in the claim period 2006-2008 and 2013-2015, respectively. For comparison, DAJ data on caries from 2000 before the introduction of FU were also considered.

Results: Of the 2.14 million children born in 2002/2003, an average of 678,000 (31.7 %) attended FU between the ages of 3 and 5, for which the GKV spent €14.7 million. For children born in 2009/2010, the FU share increased by 4.8 % to 36.5 % (762,000 out of 2.09 million children) and the costs amounted to €19.5 million. Between the two birth cohorts the dmft value decreased by 9.6 % from 1.99 to 1.80 with a cost increase of €4.8 million (+32.7 %). Before the introduction of the FU in 2000, the dmft value was 2.36.

Conclusion: The introduction of FU services correlates with the improvement of the dental health of children in Germany. Age groups in which proportionately more FU services were used were able to record a greater reduction in the dmft value when they started school. However, for methodological reasons, a direct causal relationship cannot be derived from the data. Since only about a third of the children received FU services, a larger effect can be assumed with greater use. The here described caries reduction associated with FU services, which does not consider the influence of other factors, was accompanied by a disproportionate increase in costs.