Dental Caries (Tooth Decay) in Adolescents (Ages 12 to 19 Years)

Dental Caries in the Permanent (Adult) Teeth (Ages 12 to 19)

Dental caries (tooth decay), both treated and untreated, has declined among adolescents ages 12 to 19 years from the early 1970s until the most recent National Health and Nutrition Examination Survey (NHANES). In spite of this decline, significant disparities are still found in some population groups.

Units of Measure: Dental caries is measured by a dentist examining a person’s teeth, and recording the ones with untreated decay, ones that are missing, and those with fillings. This examination provides four important numbers for individuals who have had at least one decayed, missing, or filled tooth:

DT (decayed teeth): the number of decayed teeth that have not been treated, which measures unmet need for dental care
FT (filled teeth): the number of decayed teeth that have been treated, which indicates access to dental care
MT (missing teeth): the number of missing teeth due to disease
DMFT (decayed, missing, and filled teeth): the sum of DT, MT, and FT; it is the measure of a person’s total lifetime tooth decay in permanent (adult) teeth

The following are highlights from the most recent statistics on dental caries among adolescents:

Prevalence (Table 1)

Overall, nearly 57% of adolescents 12 to 19 years have had dental caries in their permanent teeth.
In 2011‒2016, caries prevalence was higher in:
- Older adolescents ages 16 to 19 years (compared to 12 to 15 years)
- Mexican American adolescents (compared to non-Hispanic White adolescents)
- Adolescents in low-income families (compared to high-income families)

Unmet Needs (Table 2)

During the current survey period, about 10% of adolescents 12 to 19 years had untreated decay, compared to nearly 20% in 1999‒2004.
In 2017‒March 2020, untreated caries prevalence was higher in:
- Older adolescents ages 16 to 19 years (compared to 12 to 15 years)
- Mexican American adolescents (compared to non-Hispanic White adolescents)
- Adolescents in low-income families (compared to high-income families)

Severity (Table 3)

Adolescents aged 12 to 19 years had, on average, 4.2 decayed, missing, and filled teeth (DMFT), 0.4 decayed teeth (DT), 0.1 missing teeth (MT), and 3.7 filled teeth (FT) in 2017‒March 2020.
In 2017‒March 2020, the mean number of decayed, missing, and filled teeth was higher in older adolescents ages 16 to 19 years (compared to 12 to 15 years)
In 2017‒March 2020, the mean number of decayed teeth was higher in:
- Female adolescents (compared to male)
- Mexican American adolescents (compared to non-Hispanic White adolescents)
In 2017‒March 2020, the mean number of filled teeth was higher in:
- Older adolescents ages 16 to 19 years (compared to 12 to 15 years)
- Mexican American adolescents (compared to non-Hispanic White adolescents)

Table 1. Percent of Adolescents with Caries in the Permanent Teeth

Prevalence of caries (DMFT≥1) in the permanent teeth among adolescents ages 12 to 19 years, by selected characteristics: United States, National Health and Nutrition Examination Survey, 1999–2004 and 2011–2016.
Characteristic	1999–2004		2011–2016
	%	SE	%	SE
Total	59.4	0.95	56.8	1.18
Age (years)
12-15 (reference)	50.9	1.17	47.6	1.67
16-19	67.9	1.37	65.9*	1.45
Sex
Male (reference)	55.9	1.24	55.9	1.48
Female	63.1	1.26	57.7	1.51
Race and ethnicity
White, non-Hispanic (reference)	57.9	1.57	54.3	1.63
Black, non-Hispanic	55.0	1.65	57.1	2.01
Mexican American	65.0	1.44	68.9*	2.55
Poverty status
High poverty	65.8	1.38	64.9*	2.13
Middle poverty	64.9	1.50	65.3*	1.93
Low poverty (reference)	54.2	1.49	48.7	1.72
Poverty status
High and middle poverty combined	65.2	0.96	65.0*	1.38
Low poverty (reference)	54.2	1.49	48.7	1.72

Data source: All estimates are adjusted by age (single years) to the U.S. 2000 standard population. Estimates are based on all U.S. race and ethnicity groups, except the estimates for specific race and ethnicity categories. NR = Not reported because the sample size is <30 or the standard error is >30% of the point estimate value. SE = standard error. Reference groups were used to test for statistical differences within sociodemographic characteristics.
* P <0.05 based on t-test for differences against the reference group.
^a Defined as the percentage of family income relative to the federal poverty level (FPL). High poverty = <100% FPL; middle poverty = 100%–199% FPL; high or middle poverty combined = <200% FPL; and low poverty = ≥200% FPL.

Table 2. Percent of Adolescents with Untreated Decay in the Permanent Teeth

Prevalence of untreated decay (DT≥1) in the permanent teeth among adolescents ages 12 to 19 years, by selected characteristics: United States, National Health and Nutrition Examination Survey, 1999–2004, 2011–2016, and 2017‒March 2020.
Characteristic	1999–2004		2011–2016		2017–March 2020
	%	SE	%	SE	%
Total	19.6	1.05	16.6	0.99	10.4	1.05
Age (years)
12–15 (reference)	16.9	0.98	12.7	0.93	8.6	1.21
16–19	22.2	1.45	20.4*	1.43	12.1*	1.48
Sex
Male (reference)	19.9	1.22	17.7	1.25	11.7	1.47
Female	19.3	1.30	15.4	1.37	9.0	0.99
Race and ethnicity
White, non-Hispanic (reference)	15.9	1.46	15.6	1.45	11.7	2.02
Black, non-Hispanic	25.7	1.41	20.4*	1.88	12.9	2.57
Mexican American	28.6	1.54	20.8*	1.85	6.9*	1.22
Poverty status
High poverty	27.2	1.99	22.7*	1.55	14.1*	2.42
Middle poverty	27.0	1.82	20.9*	1.76	12.4	2.18
Low poverty (reference)	12.9	1.33	11.1	1.30	8.2	1.37
Poverty status
High and middle poverty combined	26.9	1.52	21.6*	1.19	13.2*	1.47
Low poverty (reference)	12.9	1.33	11.1	1.30	8.2	1.37

Note: The 2017–March 2020 NHANES data cycle was partially disrupted by COVID-19; data were released as a combined pre-pandemic dataset and may not be directly comparable to earlier continuous NHANES cycles.

Table 3. Adolescents, Severity of Decay Measured by Number of Permanent Teeth Affected

Mean number of untreated decayed (DT), missing (MT), filled (FT), and decayed, missing, or filled (DMFT) permanent teeth among adolescents ages 12 to 19 years with at least one DMFT, by selected characteristics: United States, National Health and Nutrition Examination Survey, 1999–2004, 2011–2016, and 2017‒March 2020.
Characteristic	1999–2004								2011–2016								2017–March 2020
	DMFT		DT		MT		FT		DMFT		DT		MT		FT		DMFT		DT		MT		FT
	Mean	SE	Mean	SE	Mean	SE	Mean	SE	Mean	SE	Mean	SE	Mean	SE	Mean	SE	Mean	SE	Mean	SE	Mean	SE	Mean	SE
Total	4.1	0.08	0.8	0.06	0.1	0.01	3.3	0.10	4.3	0.10	0.7	0.05	0.1	0.02	3.4	0.11	4.2	0.13	0.4	0.04	0.1	0.01	3.7	0.12
Age (years)
12–15 (reference)	3.4	0.11	0.7	0.06	0.1	0.01	2.7	0.14	3.6	0.12	0.6	0.06	0.1	0.02	2.9	0.13	3.5	0.16	0.4	0.06	0.1	0.01	3.0	0.14
16–19	4.8	0.11	0.8	0.08	0.1	0.02	3.9	0.11	4.9*	0.14	0.8*	0.06	0.1	0.02	4.0*	0.14	4.9*	0.17	0.4	0.05	0.1	0.02	4.4*	0.17
Sex
Male (reference)	4.0	0.11	0.9	0.09	0.1	0.02	3.0	0.10	4.1	0.11	0.8	0.08	0.1	0.02	3.2	0.13	4.4	0.23	0.5	0.06	0.1	0.02	3.9	0.22
Female	4.3	0.10	0.7	0.06	0.1	0.01	3.5	0.13	4.4	0.15	0.6	0.06	0.1	0.02	3.7*	0.14	3.9	0.13	0.3*	0.04	0.1	0.01	3.5	0.13
Race and ethnicity
White, non-Hispanic (reference)	4.2	0.12	0.7	0.10	0.1	0.02	3.4	0.14	4.1	0.14	0.7	0.08	0.1	0.03	3.3	0.15	4.0	0.16	0.5	0.09	0.1	0.02	3.5	0.15
Black, non-Hispanic	3.9	0.10	1.0	0.08	0.2	0.02	2.8	0.14	4.5	0.19	0.9	0.13	0.1	0.02	3.5	0.20	4.4	0.3	0.5	0.09	NR	NR	3.7	0.32
Mexican American	4.3	0.13	1.0	0.07	0.1	0.01	3.2	0.15	4.6*	0.15	0.8	0.08	0.0*	0.01	3.7	0.16	4.5	0.29	0.2*	0.04	NR	NR	4.3*	0.27
Poverty status
High poverty	4.3	0.17	1.0	0.10	0.1	0.02	3.2	0.21	4.8*	0.18	1.0*	0.09	0.2	0.04	3.7	0.16	4.7	0.22	0.5	0.11	NR	NR	4.1	0.2
Middle poverty	4.2	0.15	1.1	0.13	0.1	0.02	3.0	0.13	4.4*	0.15	0.8*	0.08	0.1	0.01	3.5	0.15	4.3	0.28	NR	NR	0.1	0.01	3.7	0.24
Low poverty (reference)	4.0	0.13	0.5	0.07	0.1	0.01	3.4	0.12	3.9	0.17	0.5	0.08	0.1	0.02	3.4	0.18	4.0	0.22	0.3	0.06	0.1	0.01	3.6	0.21
Poverty status
High and middle poverty combined	4.3	0.12	1.0	0.09	0.1	0.02	3.1	0.13	4.6*	0.12	0.9*	0.05	0.1	0.02	3.6	0.11	4.5	0.2	0.6	0.10	0.1	0.01	3.9	0.17
Low poverty (reference)	4.0	0.13	0.5	0.07	0.1	0.01	3.4	0.12	3.9	0.17	0.5	0.08	0.1	0.02	3.4	0.18	4.0	0.22	0.3	0.06	0.1	0.01	3.6	0.21

References

Centers for Disease Control and Prevention. Oral Health Surveillance Report: Trends in Dental Caries and Sealants, Tooth Retention, and Edentulism, United States, 1999–2004 to 2011–2016. Atlanta, GA: Centers for Disease Control and Prevention, U.S. Department of Health and Human Services; 2019.

Centers for Disease Control and Prevention. Oral Health Surveillance Report: Dental Caries, Tooth Retention, and Edentulism, United States, 2017–March 2020. Atlanta, GA: U.S. Department of Health and Human Services; 2024.

Last Reviewed
June 2026