Dental Caries (Tooth Decay) in Seniors (Aged 65 and Older)

Dental Caries in the Permanent (Adult) Teeth

Total dental caries, both treated and untreated, declined in adults ages 65 years and older from the early 1970s until 1999–2004, before it increased in the 2011‒2016 National Health and Nutrition Examination Survey (NHANES). The prevalence of untreated decay and severity of decay, however, have continued to decline despite significant disparities among some population groups.

Note: Prevalence estimates on this web page apply only to senior adults who have teeth. Approximately 17% of senior adults aged 65 years and older have no teeth.

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 the ones with fillings. This examination provides four important numbers:

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
DFT (decayed and filled teeth): the sum of DT and FT; it is the measure of a person’s total lifetime tooth decay (caries experience)
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

Prevalence (Table 1)

96% of seniors have had decay in their teeth in 2011–2016, a 3% increase from 1999–2004.
In 2011‒2016, caries prevalence was higher in:
- Non-Hispanic Black seniors and Mexican American seniors (compared to non-Hispanic White seniors)
- Seniors in low-income families (compared to high-income families)
- Seniors with low education (compared to high education)
- Current smokers (compared to never smokers)

Unmet Needs (Table 2)

There was a decrease in prevalence of untreated decay among seniors from 18.1% in 1999–2004 to 12.5% in 2017–March 2020.
In 2017‒March 2020, untreated caries prevalence was higher in:
- Non-Hispanic Black seniors and Mexican American seniors (compared to non-Hispanic White seniors)
- Seniors in low-income families (compared to high-income families)
- Seniors with low education (compared to high education)
- Current smokers (compared to never smokers)

Severity (Table 3)

Seniors had, on average, 16 decayed, missing, and filled teeth (DMFT), 9.6 decayed and filled teeth (DFT), 0.2 decayed teeth (DT), 6.4 missing teeth (MT), and 9.3 filled teeth (FT) in 2017‒March 2020.
In 2017‒March 2020, the mean number of decayed, missing, and filled teeth was higher in:
- Seniors ages 75+ (compared to ages 65 to 74 years)
- Mexican American seniors (compared to non-Hispanic White seniors)
- Adults with high school education (compared to more than high school education)
- Current and former smokers (compared to never smokers)

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

Prevalence of caries (DMFT ≥1) in the permanent teeth among senior adults aged 65 years and older, by selected characteristics: United States, National Health and Nutrition Examination Survey, 1999–2004 and 2011–2016.
Characteristic	1999–2004		2011–2016
	%	SE	%	SE
Total	93	0.64	96.2	0.51
Age (years)
65-74 (reference)	93.2	0.8	96.4	0.65
≥75	92.7	0.9	96	0.65
Sex
Male (reference)	93.6	0.90	96.1	0.67
Female	92.5	0.82	96.3	0.62
Race and ethnicity
White, non-Hispanic (reference)	94.8	0.72	98.2	0.44
Black, non-Hispanic	79.8	2.98	85.7*	1.93
Mexican American	84.1	1.83	85.3*	2.86
Poverty status
High poverty	83.7	2.49	88.1*	2.17
Middle poverty	90.9	1.38	94.0*	0.99
Low poverty (reference)	95.5	0.70	98.2	0.43
Poverty status
High and middle poverty combined	89.1	1.13	92.4*	1.10
Low poverty (reference)	95.5	0.70	98.2	0.43
Education
<High school	83.8	1.6	89.1*	1.52
High school	94.3	1.24	95.3*	1.09
>High school (reference)	97.2	0.63	98.3	0.33
Cigarette smoking history
Current smoker	89.6	2.46	89.8*	2.66
Former smoker	93.5	0.95	96.2	0.79
Never (reference)	93	0.9	96.8	0.57

Data source: All estimates are adjusted by age (5-year groups) 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 Seniors with Untreated Decay in Permanent Teeth

Prevalence of untreated decay (DT≥1) in the permanent teeth among senior adults aged 65 years and older, 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	%	SE
Total	18.1	1.01	15.9	1.20	12.5	1.09
Age (years)
65-74 (reference)	17.0	1.37	15.4	1.55	12.4	1.33
≥75	19.5	1.28	16.5	1.40	12.6	2.04
Sex
Male (reference)	20.4	1.34	18.0	1.53	14.0	1.5
Female	16.4	1.18	14.2*	1.25	11.2	1.2
Race and ethnicity
White, non-Hispanic (reference)	15.8	1.24	13.4	1.25	9.3	1.21
Black, non-Hispanic	37.1	3.48	29.1*	2.49	28.4*	2.58
Mexican American	42.1	3.07	35.9*	3.24	24.0*	6.64
Poverty status
High poverty	33.4	3.42	33.1*	3.18	28.7*	3.45
Middle poverty	23.8	1.75	26.9*	2.64	19.4*	2.62
Low poverty (reference)	14.2	1.20	9.9	1.27	7.9	0.86
Poverty status
High and middle poverty combined	26.2	1.75	28.6*	2.30	21.5*	2.4
Low poverty (reference)	14.2	1.20	9.9	1.27	7.9	0.86
Education
<High school	26.2	2.33	30.8*	2.76	20.0*	3.36
High school	17.7	1.39	18.8*	2.22	14.9*	2.04
>High school (reference)	14.2	1.27	11.7	1.35	10.2	0.97
Cigarette smoking history
Current smoker	27.6	3.66	33.9*	5.10	27.6*	6.36
Former smoker	18.6	1.31	15.3	1.67	13.9	2.35
Never (reference)	16.5	1.30	14.2	1.37	9.7	0.94

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. Seniors, Severity of Decay Measured by Number of Permanent Teeth Affected

Mean number of untreated decayed (DT), missing (MT), filled (FT), decayed and filled (DFT), and decayed, missing, or filled (DMFT) permanent teeth among senior adults aged 65 years and older 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		DFT		DT		MT		FT		DMFT		DFT		DT		MT		FT		DMFT		DFT		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	Mean	SE	Mean	SE	Mean	SE
Total	18.0	0.23	9.1	0.21	0.4	0.04	8.8	0.23	8.7	0.23	16.7	0.14	10.1	0.20	0.3	0.03	6.6	0.21	9.8	0.21	16.0	0.24	9.6	0.23	0.2	0.02	6.4	0.28	9.3	0.23
Age (years)
65–74 (reference)	17.7	0.25	9.3	0.24	0.4	0.05	8.3	0.28	9.0	0.26	15.9	0.21	10.2	0.23	0.3	0.03	5.6	0.23	9.9	0.24	14.8	0.36	9.2	0.26	0.2	0.03	5.6	0.39	9.0	0.27
≥75	18.3	0.29	8.9	0.26	0.5	0.05	9.4	0.30	8.4	0.28	17.8*	0.21	9.9	0.27	0.3	0.03	7.9*	0.30	9.6	0.28	17.4*	0.22	10.0	0.32	0.2	0.03	7.4*	0.29	9.7	0.32
Sex
Male (reference)	17.6	0.27	8.9	0.22	0.5	0.05	8.7	0.29	8.3	0.25	16.6	0.22	10.1	0.26	0.4	0.04	6.5	0.28	9.7	0.27	15.7	0.34	9.3	0.3	0.3	0.03	6.5	0.36	9.0	0.32
Female	18.3	0.25	9.3	0.27	0.4	0.04	9.0	0.28	9.0	0.29	16.9	0.17	10.0	0.22	0.3*	0.03	6.8	0.25	9.8	0.23	16.2	0.23	9.8	0.27	0.2*	0.02	6.4	0.32	9.6	0.27
Race and ethnicity
White, non-Hispanic (reference)	18.2	0.24	9.9	0.22	0.4	0.04	8.3	0.25	9.6	0.24	16.8	0.17	11.1	0.19	0.3	0.03	5.8	0.22	10.8	0.19	16.2	0.3	10.5	0.24	0.2	0.02	5.6	0.38	10.4	0.24
Black, non-Hispanic	16.9	0.40	4.2	0.31	1.1	0.15	12.7	0.49	3.2	0.30	16.2	0.40	5.1*	0.27	0.7*	0.08	11.2*	0.43	4.4*	0.29	15.8	0.33	5.2*	0.35	0.5*	0.04	10.6*	0.42	4.7*	0.36
Mexican American	15.3	0.42	5.4	0.45	1.2	0.09	9.9	0.36	4.2	0.48	14.6*	0.60	5.7*	0.53	1.0*	0.15	8.8*	0.45	4.8*	0.53	14.9*	0.47	7.4*	0.42	0.3*	0.08	7.6*	0.67	7.0*	0.43
Poverty status
High poverty	17.3	0.51	5.1	0.38	1.0	0.15	12.2	0.73	4.1	0.35	16.5	0.42	5.7*	0.43	0.9*	0.10	10.8*	0.54	4.8*	0.45	17.2	0.64	6.1*	0.6	0.5*	0.07	11.2*	0.89	5.6*	0.59
Middle poverty	18.2	0.48	7.4	0.39	0.6	0.07	10.8	0.52	6.9	0.42	17.0	0.29	8.2*	0.28	0.6*	0.07	8.8*	0.39	7.6*	0.29	16.3	0.35	7.4*	0.26	0.4*	0.07	8.9*	0.48	7.0*	0.31
Low poverty (reference)	18.1	0.21	10.5	0.16	0.3	0.04	7.6	0.22	10.2	0.17	16.8	0.19	11.5	0.21	0.2	0.03	5.3	0.21	11.3	0.21	15.8	0.32	10.5	0.29	0.1	0.03	5.3	0.39	10.4	0.3
Poverty status
High and middle poverty combined	18.0	0.46	6.8	0.31	0.7	0.08	11.1	0.47	6.2	0.34	16.8	0.25	7.5*	0.28	0.7*	0.07	9.3*	0.34	6.8*	0.30	16.5	0.34	7.1*	0.22	0.4*	0.06	9.4*	0.45	6.7*	0.25
Low poverty (reference)	18.1	0.21	10.5	0.16	0.3	0.04	7.6	0.22	10.2	0.17	16.8	0.19	11.5	0.21	0.2	0.03	5.3	0.21	11.3	0.21	15.8	0.32	10.5	0.29	0.1	0.03	5.3	0.39	10.4	0.3
Education
<High school	17.7	0.37	5.7	0.30	0.8	0.11	12.0	0.39	4.9	0.36	16.5	0.38	6.1*	0.27	0.7*	0.08	10.3*	0.37	5.4*	0.28	15.9	0.46	5.3*	0.38	0.4*	0.08	10.6*	0.59	4.9*	0.35
High school	18.4	0.34	8.8	0.29	0.4	0.06	9.6	0.36	8.4	0.30	17.1	0.32	8.9*	0.40	0.4*	0.05	8.1*	0.34	8.5*	0.41	16.7*	0.43	8.9*	0.45	0.2	0.03	7.8*	0.52	8.7*	0.46
>High school (reference)	17.9	0.23	11.2	0.21	0.3	0.04	6.7	0.25	10.9	0.22	16.7	0.20	11.4	0.20	0.2	0.03	5.2	0.22	11.2	0.21	15.7	0.23	10.6	0.29	0.2	0.03	5.1	0.32	10.4	0.29
Cigarette smoking history
Current smoker	19.0	0.49	6.5	0.59	0.8	0.14	12.5	0.73	5.7	0.61	18.0*	0.57	7.2*	0.69	0.8*	0.15	10.8*	0.77	6.4*	0.74	18.2*	0.73	7.8*	0.79	NR	NR	10.4*	0.77	7.2*	0.85
Former smoker	18.4	0.24	8.8	0.22	0.4	0.05	9.6	0.29	8.4	0.24	17.2*	0.24	10.0	0.26	0.3	0.04	7.2*	0.30	9.7	0.27	16.4*	0.36	9.4	0.28	0.2	0.04	7.0*	0.48	9.1	0.29
Never (reference)	17.5	0.31	9.7	0.29	0.4	0.05	7.8	0.33	9.3	0.32	16.1	0.19	10.4	0.26	0.3	0.03	5.7	0.26	10.1	0.27	15.4	0.22	9.9	0.3	0.2	0.02	5.5	0.27	9.7	0.3

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