{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T19:46:32Z","timestamp":1774381592248,"version":"3.50.1"},"reference-count":53,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2024,11,26]],"date-time":"2024-11-26T00:00:00Z","timestamp":1732579200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background: Nationally representative long-term data on caries in the primary dentition are rare but essential for determining the need for prevention and treatment. This research assessed the prevalence and trends of dental caries in 3-year-old children across Germany, with national data analyzed and compared with the corresponding data for 6\u20137-year-olds. Methods: Data were extracted from the most recent German National Oral Health Survey in 2016. Children aged 3 years were examined by calibrated dentists in 10 German regions using the WHO criteria for d3\u20134mft, including assessment of initial carious lesions d1\u20132mft. In addition, the Significant Caries Index (SiC), the Care Index (CI) and the Specific Affected Caries Index (SaC) were considered to identify provision of care and risk groups. Results: In a total of 95,127 3-year-old preschool children, caries prevalence was 13.7% with a mean d3\u20134mft of 0.48. Including initial carious lesions, prevalence increased to 18.7% (mean 0.67 d1\u20134mft). Dependent on the German region, d3\u20134mft values varied noticeably from 0.38 (Schleswig-Holstein) to 0.58 (Saxony-Anhalt and Berlin). Comparing data from 3-year-olds to 6\u20137-year-olds, the d3\u20134mft value for 6\u20137-year-olds (1.73) was more than three times higher than that for 3-year-olds (0.48). The SiC value was 1.47 for 3-year-olds and 4.88 for 6\u20137-year-olds, while the SaC values were 3.57 and 3.97, respectively. The Care Index was low for both groups (26.1% and 57.5%, respectively). Conclusions: Germany exhibited a high level of dental caries in the primary dentition for 3 (13.7%) to 6\u20137-year-olds (44%) children. This large cross-sectional study revealed considerable room for improvement in the early caries prevention and treatment within the well-equipped German dental health infrastructure.<\/jats:p>","DOI":"10.3390\/children11121426","type":"journal-article","created":{"date-parts":[[2024,11,26]],"date-time":"2024-11-26T04:02:18Z","timestamp":1732593738000},"page":"1426","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Caries Level in 3-Year-Olds in Germany: National Caries Trends and Gaps in Primary Dental Care"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1322-6351","authenticated-orcid":false,"given":"Ruth M.","family":"Santamar\u00eda","sequence":"first","affiliation":[{"name":"Pediatric Dentistry Department, University Medicine of Greifswald, 17475 Greifswald, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian H.","family":"Splieth","sequence":"additional","affiliation":[{"name":"Pediatric Dentistry Department, University Medicine of Greifswald, 17475 Greifswald, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roger","family":"Basner","sequence":"additional","affiliation":[{"name":"Pediatric Dentistry Department, University Medicine of Greifswald, 17475 Greifswald, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisabeth","family":"Schankath","sequence":"additional","affiliation":[{"name":"Pediatric Dentistry Department, University Medicine of Greifswald, 17475 Greifswald, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2436-3001","authenticated-orcid":false,"given":"Julian","family":"Schmoeckel","sequence":"additional","affiliation":[{"name":"Pediatric Dentistry Department, University Medicine of Greifswald, 17475 Greifswald, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,11,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"277","DOI":"10.12968\/denu.2013.40.4.277","article-title":"Changing concepts in cariology: Forty years on","volume":"40","author":"Kidd","year":"2013","journal-title":"Dent. 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