Untreated Tooth Decay Common in US Adults, CDC Says

Megan Brooks

May 13, 2015

While the oral health of Americans has improved, the vast majority of adults in the United States had cavities in 2011-2012, and more than a quarter had untreated tooth decay, according to a new data brief from the Centers for Disease Control and Prevention's National Center for Health Statistics (NCHS).

"Having good oral health is important for healthy aging and poor oral health impacts quality of life by causing pain and limiting food choices," Bruce A. Dye, DDS, MPH, dental epidemiology officer with the National Institute of Dental and Craniofacial Research, part of the National Institutes of Health, said during a media briefing today.

"Many people also avoid social interactions because of perceived poor oral health. Overall, oral health for most adults has improved dramatically since the 1960s, but we still need to make more progress in improving oral health for all adults in the US," Dr Dye noted.

Cavities and tooth loss are important oral health indicators for adults and are key measures for monitoring progress toward health promotion goals set by Healthy People 2020. The data brief released today describes US adult dental caries and tooth loss by age and race and Hispanic origin for 2011-2012 based on data from the National Health and Nutrition Examination Survey.

During that period, roughly nine in 10 (91%) adults aged 20 to 64 years had dental caries in permanent teeth, with a higher prevalence in adults aged 35 to 64 years (94% to 97%) compared with adults aged 20 to 34 years (82%), according to the report. The prevalence of cavities was lower for Hispanic (85%), non-Hispanic Asian (85%), and non-Hispanic black (86%) adults compared with non-Hispanic white adults (94%).

Overall, 27% of adults aged 20 to 64 years had untreated tooth decay, as did nearly one in five (19%) adults aged 65 years or older.

Untreated tooth decay "disproportionately affects some race/ethnic groups in the United States," Dr Dye said, with a higher prevalence in Hispanic (36%) and non-Hispanic black (42%) adults compared with non-Hispanic white (22%) and non-Hispanic Asian (17%) adults.

Dentures Inevitable?

Nearly 19% of adults aged 65 years or older had no natural teeth remaining, with little difference between men and women. Edentulism was twice as prevalent among adults aged 75 years or older compared with their younger peers aged 65 to 74 years. Among those aged 65 years or older, complete tooth loss was lower for older Hispanic (15%) and non-Hispanic white (17%) adults compared with older non-Hispanic black adults (29%).

Yet the trend in tooth loss is actually encouraging, Dr Dye said. "In 1960 to '62, there were about 11 million adults aged 65 to 74 in the US and 49% were edentulous. In 2011-2012, there were about 21 million adults aged 65 to 74 and 13% were edentulous. This change is pretty remarkable and means that for many Americans, dentures are no longer inevitable," he added.

In addition, in 2011-2012, nearly half (48%) of all adults aged 20 to 64 years had not lost a tooth due to dental disease, Dr Dye reported. "More adults are keeping their teeth and as we retain more teeth we have more teeth that can become susceptible to tooth decay," he noted.

Tooth decay also remains a problem in US children, especially teenagers, with more than half of 12- to 19-year-olds having one or more cavities in adult teeth, according to a NCHS data brief published in March.

Dental Caries and Tooth Loss in Adults in the United States, 2011-2012. NCHS Data Brief No. 197. Published online May 13, 2015. Full text

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