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

Note: Prevalence estimates on this web page apply only to adults 20 to 64 years who have teeth. Approximately 2% of adults ages 20 to 64 years have no 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 2011–2016 National Health and Nutrition Examination Survey. The decrease was significant in all population subgroups. Despite 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 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)

• 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.
• In 2011‒2016, caries prevalence was higher in:
  • Older adults ages 35 to 49 and 50 to 64 years (compared to ages 20 to 34 years)
  • Female adults (compared to male)
  • Non-Hispanic Black adults and Mexican American adults (compared to non-Hispanic White adults)
  • Adults in low-income families (compared to high-income families)
  • Adults with low education (compared to high education)
  • Current smokers (compared to never smokers)

Unmet Needs (Table 2)

• 1 in 5 adults ages 20 to 64 years have had untreated decay
• In 2017‒March 2020, untreated caries prevalence was higher in:
  • Older adults ages 50 to 64 years (compared to ages 20 to 34 years)
  • Female adults (compared to male)
  • Non-Hispanic Black adults (compared to non-Hispanic White adults)
  • Adults in low-income families (compared to high-income families)
  • Adults with low education (compared to high education)
  • Current smokers (compared to never smokers)

Severity (Table 3)

• Adults had, on average, 8.6 decayed, missing, and filled teeth (DMFT), 6.6 decayed and filled teeth (DFT), 0.7 decayed teeth (DT), 2 missing teeth (MT), and 6 filled teeth (FT) in 2017‒March 2020.
• In 2017‒March 2020, the mean number of decayed, missing, and filled teeth was higher in:
  • Older adults ages 35 to 49 and 50 to 64 years (compared to ages 20 to 34 years)
  • Female adults (compared to male)
  • Non-Hispanic Black adults and Mexican American adults (compared to non-Hispanic White adults)
  • Adults in low-income families (compared to high-income families)
  • Adults with low education (compared to high education)
  • Current smokers (compared to never smokers)

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

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 Adults with Untreated Decay in the Permanent Teeth

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.

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

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.

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.

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.