Dental Caries (Tooth Decay) in Adults (Ages 20 to 64 Years)

Dental Caries in the Permanent (Adult) Teeth

Note: Approximately 2% of adults ages 20 to 64 years have no teeth. This survey applies only to those adults who have teeth.

Dental caries, both treated and untreated, in the permanent teeth of all adults ages 20 to 64 years declined from the early 1970s until the most recent (2011–2016) National Health and Nutrition Examination Survey. The decrease was significant in all population subgroups. In spite of this decline, significant disparities are still found in some population groups.

Prevalence (Table 1)

• Nearly 90% of adults ages 20 to 64 years have had decay in their teeth, a percentage that has not changed significantly between the 1999–2004 and 2011–2016 NHANES cycles.
• Older working-age adults 50 to 64 years had the greatest prevalence of decay (96%) in both NHANES cycles.
• Decay is more prevalent in people who currently smoke compared with those who never or formerly smoked.
• There was a slight decrease in decay prevalence among younger groups of adults and a significant decrease in white adults and for those with higher incomes and education between the two NHANES cycles.

Unmet Needs (Table 2)

• 1 in 4 adults ages 20 to 64 years have had untreated decay in both NHANES cycles.
• When compared to their counterparts, black and Mexican American adults, younger adults, those with lower incomes and less education, and those who currently smoke were more likely to have untreated decay.

Severity (Table 3)

• Adults ages 20 to 64 years had an average of 9.3 decayed, missing, or filled teeth in 2011–2016.
• Black and Mexican American subgroups and those with lower incomes and less education had more untreated decay compared to their counterparts.
• There was a significant decrease in the severity of tooth decay (DMFT) for nearly all adults of all ages between the two NHANES cycles.

Tables 1 through 3 present selected caries estimates in the permanent teeth for adults ages 20 to 64 years and for selected subgroups.

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 provides four important numbers:

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

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

Data Source: 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. Dept of Health and Human Services; 2019.

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

Data Source: 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. Dept of Health and Human Services; 2019.

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

Data Source: 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. Dept of Health and Human Services; 2019.