Caries in Adults in the United States

Prevalence of Untreated Tooth Decay in Adults in the United States¹⁴

Nearly 21% of adults aged 20-64 years had untreated decay in permanent teeth. The prevalence was lower in the 50-64 age group (17.3%) compared to younger age groups (21.8% for 20-34 years and 21.4% for 35-49 years). Higher prevalence was observed among males (22.8%), non-Hispanic Black adults (30.3%), those in high (39.6%) and middle (30.9%) poverty groups, those with a high school education (30.2%) or less (39.1%), and current smokers (41.4%).

One interesting finding related to DMFT and DMFS scores in adults was that there were no significant differences based on poverty levels, as was found in children. Also, it was found that non-Hispanic Black adults have the highest prevalence of untreated caries, and men are more affected than women. It is most likely because women seek dental care more frequently than men, and women experience earlier tooth eruption patterns.

Prevalence of Untreated Tooth Decay in Older Adults¹⁴

Nearly 13% of adults aged 65 years or older had untreated decay in permanent teeth. The root caries prevalence was significantly higher among non-Hispanic Black adults (28.4%), Mexican American adults (24.0%), those in high (28.7%) and middle (19.4%) poverty groups, those with less than a high school education (20.0%), and current smokers (27.6%). This emphasizes the need for targeted interventions to address root caries in these high-risk populations.

Tooth Retention and Edentulism¹⁴

The mean number of permanent teeth decreased with age, from 27 teeth at 20-34 years to 23.3 at 50-64 years, 21.7 at 65-74 years, and 19.8 at 75 years or older. Among adults aged 65 years or older, the mean number of teeth was lower among non-Hispanic Black adults (16.2), those in high and middle poverty groups combined (17.6), those with less than a high school education (16.8), and current smokers (16.3). The prevalence of edentulism increased from 1.2% at 35-49 years to 5.9% at 50-64 years, 11.4% at 65-74 years, and 19.7% at 75 years or older. Edentulism was more prevalent among non-Hispanic Black adults (21.8%), those in high poverty groups (29.8%), those with less than a high school education (33.4%), and current smokers (29.4%).

Figure 1.

Figure 1.

Adapted from ORAL HEALTH SURVEILLANCE REPORT Dental Caries, Tooth Retention, and Edentulism, United States 2017–March 2020