Dental and oral health assessments in the German National Cohort (NAKO)
Abstract Background Despite considerable improvements in oral health in recent decades, caries and periodontitis are still widespread, ranking among the most prevalent diseases worldwide and requiring future research. The German National Cohort (NAKO Gesundheitsstudie, NAKO) is a large-scaled, multi...
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2025-01-01
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| Online Access: | https://doi.org/10.1186/s12903-025-05454-z |
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| author | Stefanie Samietz Katrin Borof Katrin Hertrampf Ghazal Aarabi Antonio Ciardo Hannah Finke Daniel Hagenfeld Jan Kühnisch Maurice Rütters Sebastian-Edgar Baumeister Stefan Lars Reckelkamm Ti-Sun Kim Thomas Kocher Wolfgang Ahrens Hermann Brenner Carina Emmel Beate Fischer Amand Führer Karin Halina Greiser Jasmin Grischke Kathrin Günther Volker Harth Stefanie Jaskulski André Karch Thomas Keil Yvonne Kemmling Alexander Kluttig Lilian Krist Oliver Kuss Michael Leitzmann Claudia Meinke-Franze Karin B. Michels Nadia Obi Anette Peters Nicole Pischon Tobias Pischon Sabine Schipf Börge Schmidt Henning Teismann Stefan Rupf Birte Holtfreter |
| author_facet | Stefanie Samietz Katrin Borof Katrin Hertrampf Ghazal Aarabi Antonio Ciardo Hannah Finke Daniel Hagenfeld Jan Kühnisch Maurice Rütters Sebastian-Edgar Baumeister Stefan Lars Reckelkamm Ti-Sun Kim Thomas Kocher Wolfgang Ahrens Hermann Brenner Carina Emmel Beate Fischer Amand Führer Karin Halina Greiser Jasmin Grischke Kathrin Günther Volker Harth Stefanie Jaskulski André Karch Thomas Keil Yvonne Kemmling Alexander Kluttig Lilian Krist Oliver Kuss Michael Leitzmann Claudia Meinke-Franze Karin B. Michels Nadia Obi Anette Peters Nicole Pischon Tobias Pischon Sabine Schipf Börge Schmidt Henning Teismann Stefan Rupf Birte Holtfreter |
| author_sort | Stefanie Samietz |
| collection | DOAJ |
| description | Abstract Background Despite considerable improvements in oral health in recent decades, caries and periodontitis are still widespread, ranking among the most prevalent diseases worldwide and requiring future research. The German National Cohort (NAKO Gesundheitsstudie, NAKO) is a large-scaled, multidisciplinary, nationwide, multi-centre, population-based, prospective cohort study with oral examinations that aims to provide a resource to study risk factors for major diseases. The aim of the present article is to provide the methodological background, to report on the data quality, and to present initial results of the oral examinations. Methods During baseline examinations (2014–2019), a total of 205,184 persons aged 19–74 years has been examined in 18 study centres, including, among others, a dental interview, stimulated saliva sampling, and recording of the numbers of present teeth and prostheses (standard Level 1 program). As part of the Level 2 program that was offered to 20% randomly selected participants, each study centre selected one of three modules, one of them being the Level 2 oral examination. This extended program was carried out in a subgroup of 20,828 participants, including collection of detailed information on the dental and prosthetic status as well as on periodontal, cariological and functional aspects. To ensure reliability and reproducibility, study nurses were trained and calibrated by dental experts. In addition, a reliability study was conducted among 794 Level 1 and 359 Level 2 participants, reporting intra class correlation and kappa coefficients. Results Intra class correlation and kappa coefficients for observer agreement and reliability were consistently above 0.7, indicating good to excellent reliability of all dental measurements. For example, intra class correlation was 0.937 for the number of present teeth (Level 1), 0.740 for mean probing depth (PD) and 0.797 for active mouth opening. An initial inspection of the data showed that the median number of present teeth was 27, of which on average 6.9 teeth were healthy and caries-free. Average mean PD was 1.92 mm. An orthodontic treatment was reported by 35.5% of participants. Discussion Overall, the dental study protocol was feasible and successfully integrated into the NAKO’s overall assessment program. However, rigorous support of the study centres by dental professionals was required to ensure high quality data. In summary, high-quality data collection within the NAKO pave the way for future investigation of potential risk factors for oral diseases and links between oral and systemic diseases and conditions. |
| format | Article |
| id | doaj-art-24ae3ae7a43d42deb143b8ef30b37f79 |
| institution | Kabale University |
| issn | 1472-6831 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Oral Health |
| spelling | doaj-art-24ae3ae7a43d42deb143b8ef30b37f792025-02-02T12:45:11ZengBMCBMC Oral Health1472-68312025-01-0125111810.1186/s12903-025-05454-zDental and oral health assessments in the German National Cohort (NAKO)Stefanie Samietz0Katrin Borof1Katrin Hertrampf2Ghazal Aarabi3Antonio Ciardo4Hannah Finke5Daniel Hagenfeld6Jan Kühnisch7Maurice Rütters8Sebastian-Edgar Baumeister9Stefan Lars Reckelkamm10Ti-Sun Kim11Thomas Kocher12Wolfgang Ahrens13Hermann Brenner14Carina Emmel15Beate Fischer16Amand Führer17Karin Halina Greiser18Jasmin Grischke19Kathrin Günther20Volker Harth21Stefanie Jaskulski22André Karch23Thomas Keil24Yvonne Kemmling25Alexander Kluttig26Lilian Krist27Oliver Kuss28Michael Leitzmann29Claudia Meinke-Franze30Karin B. Michels31Nadia Obi32Anette Peters33Nicole Pischon34Tobias Pischon35Sabine Schipf36Börge Schmidt37Henning Teismann38Stefan Rupf39Birte Holtfreter40Department of Prosthetic Dentistry, Gerodontology and Biomaterials, University Medicine GreifswaldDepartment of Periodontics, Preventive and Restorative Dentistry, Centre for Dental and Oral Medicine, University Medical Centre Hamburg-EppendorfDepartment of Oral and Maxillofacial Surgery, University Hospital Schleswig-HolsteinDepartment of Periodontics, Preventive and Restorative Dentistry, Centre for Dental and Oral Medicine, University Medical Centre Hamburg-EppendorfSection of Periodontology, Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, Heidelberg Faculty of Medicine, Heidelberg UniversityDepartment of Orthodontics, University HospitalClinic for Periodontology and Conservative Dentistry, University of MünsterDepartment of Conservative Dentistry and Periodontology, Ludwig-Maximilian University Hospital, Ludwig-Maximilian University MunichSection of Periodontology, Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, Heidelberg Faculty of Medicine, Heidelberg UniversityInstitute of Health Services Research in Dentistry, University of MünsterClinic for Periodontology and Conservative Dentistry, University of MünsterSection of Periodontology, Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, Heidelberg Faculty of Medicine, Heidelberg UniversityDepartment of Restorative Dentistry, Periodontology and Endodontology, University Medicine GreifswaldLeibniz Institute for Prevention Research and Epidemiology – BIPSDivision of Clinical Epidemiology and Aging ResearchInstitute for Medical Informatics, Biometry and Epidemiology, University of Duisburg-EssenInstitute for Epidemiology and Preventive Medicine, University of RegensburgInstitute for Medical Epidemiology, Biometrics and Informatics, Martin Luther University Halle-WittenbergDivision of Cancer Epidemiology, German Cancer Research Centre (DKFZ)Department of Prosthetic Dentistry and Biomedical Materials Science, Hannover Medical SchoolLeibniz Institute for Prevention Research and Epidemiology – BIPSInstitute for Occupational Medicine and Maritime Medicine (ZfAM), University Medical Centre Hamburg-EppendorfInstitute for Prevention and Cancer Epidemiology, Faculty of Medicine and Medical Centre, University of FreiburgInstitute of Epidemiology and Social Medicine, University of MünsterInstitute of Social Medicine, Epidemiology and Health Economics, Charité - Universitästmedizin BerlinDepartment of Epidemiology, Helmholtz-Centre for Infection Research (HZI)Institute for Medical Epidemiology, Biometrics and Informatics, Martin Luther University Halle-WittenbergInstitute of Social Medicine, Epidemiology and Health Economics, Charité - Universitästmedizin BerlinInstitute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University DüsseldorfInstitute for Epidemiology and Preventive Medicine, University of RegensburgInstitute for Community Medicine, University Medicine GreifswaldInstitute for Prevention and Cancer Epidemiology, Faculty of Medicine and Medical Centre, University of FreiburgInstitute for Occupational Medicine and Maritime Medicine (ZfAM), University Medical Centre Hamburg-EppendorfInstitute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH)Molecular Epidemiology Research Group, Max-Delbrueck-Centre for Molecular Medicine in the Helmholtz Association (MDC)Molecular Epidemiology Research Group, Max-Delbrueck-Centre for Molecular Medicine in the Helmholtz Association (MDC)Institute for Community Medicine, University Medicine GreifswaldInstitute for Medical Informatics, Biometry and Epidemiology, University of Duisburg-EssenInstitute of Epidemiology and Social Medicine, University of MünsterSynoptic Dentistry, Saarland UniversityDepartment of Restorative Dentistry, Periodontology and Endodontology, University Medicine GreifswaldAbstract Background Despite considerable improvements in oral health in recent decades, caries and periodontitis are still widespread, ranking among the most prevalent diseases worldwide and requiring future research. The German National Cohort (NAKO Gesundheitsstudie, NAKO) is a large-scaled, multidisciplinary, nationwide, multi-centre, population-based, prospective cohort study with oral examinations that aims to provide a resource to study risk factors for major diseases. The aim of the present article is to provide the methodological background, to report on the data quality, and to present initial results of the oral examinations. Methods During baseline examinations (2014–2019), a total of 205,184 persons aged 19–74 years has been examined in 18 study centres, including, among others, a dental interview, stimulated saliva sampling, and recording of the numbers of present teeth and prostheses (standard Level 1 program). As part of the Level 2 program that was offered to 20% randomly selected participants, each study centre selected one of three modules, one of them being the Level 2 oral examination. This extended program was carried out in a subgroup of 20,828 participants, including collection of detailed information on the dental and prosthetic status as well as on periodontal, cariological and functional aspects. To ensure reliability and reproducibility, study nurses were trained and calibrated by dental experts. In addition, a reliability study was conducted among 794 Level 1 and 359 Level 2 participants, reporting intra class correlation and kappa coefficients. Results Intra class correlation and kappa coefficients for observer agreement and reliability were consistently above 0.7, indicating good to excellent reliability of all dental measurements. For example, intra class correlation was 0.937 for the number of present teeth (Level 1), 0.740 for mean probing depth (PD) and 0.797 for active mouth opening. An initial inspection of the data showed that the median number of present teeth was 27, of which on average 6.9 teeth were healthy and caries-free. Average mean PD was 1.92 mm. An orthodontic treatment was reported by 35.5% of participants. Discussion Overall, the dental study protocol was feasible and successfully integrated into the NAKO’s overall assessment program. However, rigorous support of the study centres by dental professionals was required to ensure high quality data. In summary, high-quality data collection within the NAKO pave the way for future investigation of potential risk factors for oral diseases and links between oral and systemic diseases and conditions.https://doi.org/10.1186/s12903-025-05454-zEpidemiologyCohort studyCross-sectionalCariesPeriodontitisDental status |
| spellingShingle | Stefanie Samietz Katrin Borof Katrin Hertrampf Ghazal Aarabi Antonio Ciardo Hannah Finke Daniel Hagenfeld Jan Kühnisch Maurice Rütters Sebastian-Edgar Baumeister Stefan Lars Reckelkamm Ti-Sun Kim Thomas Kocher Wolfgang Ahrens Hermann Brenner Carina Emmel Beate Fischer Amand Führer Karin Halina Greiser Jasmin Grischke Kathrin Günther Volker Harth Stefanie Jaskulski André Karch Thomas Keil Yvonne Kemmling Alexander Kluttig Lilian Krist Oliver Kuss Michael Leitzmann Claudia Meinke-Franze Karin B. Michels Nadia Obi Anette Peters Nicole Pischon Tobias Pischon Sabine Schipf Börge Schmidt Henning Teismann Stefan Rupf Birte Holtfreter Dental and oral health assessments in the German National Cohort (NAKO) BMC Oral Health Epidemiology Cohort study Cross-sectional Caries Periodontitis Dental status |
| title | Dental and oral health assessments in the German National Cohort (NAKO) |
| title_full | Dental and oral health assessments in the German National Cohort (NAKO) |
| title_fullStr | Dental and oral health assessments in the German National Cohort (NAKO) |
| title_full_unstemmed | Dental and oral health assessments in the German National Cohort (NAKO) |
| title_short | Dental and oral health assessments in the German National Cohort (NAKO) |
| title_sort | dental and oral health assessments in the german national cohort nako |
| topic | Epidemiology Cohort study Cross-sectional Caries Periodontitis Dental status |
| url | https://doi.org/10.1186/s12903-025-05454-z |
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