Prosthodontics, Carl Gustav Carus Faculty of Medicine, TU Dresden, Dresden, Germany.
Department of Orthodontics, Pediatric and Preventive Dentistry, Jena University Hospital, Jena, Germany.
Caries Res. 2021;55(5):546-553. doi: 10.1159/000518075. Epub 2021 Jun 29.
Oral health surveys are considered the gold standard for assessing the caries experience of children. Analyses of routine data offer additional opportunities not yet fully explored. This study aimed at estimating the caries treatment experience by mining an insurance claims database. Comprehensive claims data sets were extracted from the data warehouse of a major health insurance company (BARMER, Germany). A surrogate variable for caries experience was formed that reflected the proportion of children without any former potentially caries-related treatment (filling, root canal treatment, and extraction) at ages from 1 to 14 years. The statistical calculations were based on Kaplan-Meier survival analyses. The evaluation for the permanent dentition comprised N = 593,330 children at 6 years and N = 114,568 at 12 years. At 12 years of age, 66.8% had not yet experienced potentially caries-related treatments. This value hints at a significantly higher caries experience at 12 years compared to available epidemiological data. For the deciduous dentition, the respective rates were 74.0% at 6 years and 45.8% at 10 years. Although various sources of bias have to be taken into account, the potential of routine data mining is evident. The approach is supplemental to oral health surveys. It can be useful in coming closer to reality when estimating the caries experience of children. From our results, we conclude that the oral health of up to 14-year-olds in Germany remains in urgent need of improvement.
口腔健康调查被认为是评估儿童龋齿经历的金标准。对常规数据的分析提供了尚未充分探索的额外机会。本研究旨在通过挖掘保险索赔数据库来估计龋齿治疗经验。从一家主要健康保险公司(德国 BARMER)的数据仓库中提取了全面的索赔数据集。形成了一个龋齿经历的替代变量,反映了从 1 岁到 14 岁的儿童中没有任何以前潜在龋齿相关治疗(填充、根管治疗和拔牙)的比例。统计计算基于 Kaplan-Meier 生存分析。对恒牙的评估包括 N = 593,330 名 6 岁儿童和 N = 114,568 名 12 岁儿童。在 12 岁时,66.8%的儿童尚未接受过潜在的龋齿相关治疗。这一数值表明,与现有的流行病学数据相比,12 岁儿童的龋齿经历显著更高。对于乳牙,6 岁时的相应比率为 74.0%,10 岁时为 45.8%。尽管必须考虑到各种来源的偏差,但常规数据挖掘的潜力是明显的。这种方法是对口腔健康调查的补充。在估计儿童的龋齿经历时,它可以更接近现实。从我们的结果可以得出结论,德国 14 岁以下儿童的口腔健康仍急需改善。