Caries in Adults in the United States

People aged 20 to 64 were included in this group. Overall, a decrease in caries was seen in American adults with coronal caries dropping from 95% in 1988-1994 to 92% in 1998-2004, and the largest decline being seen in the 20- to 34-year age group. In the 2011-2012 update for this same age group, caries has decreased further, to 91%.12

Data collected in 1999-2004 found that 85.6% of people aged 20 to 34 had caries experience, while the prevalence was 94.3% in people aged 35 to 49, and 95.6% in people aged 50 to 64. Also of note was that there was an effect of gender: men had fewer caries compared to women (90.6% vs. 92.7%). The proportion of adults with untreated dental caries in the period 2005-2008 varied between 19.6% in people aged 65 to 74 and 25.1% in people aged 20 to 44. In the 2011-2012 update for 20-64 year olds, untreated tooth decay was found to be higher for Hispanic (36%) and non-Hispanic black (42%) adults compared with non-Hispanic white (22%) and non-Hispanic Asian (17%) adults. When combined, the 2011-2012 data showed that roughly 27% of adults, aged 20-64, had untreated tooth decay.12 Also noteworthy was that the prevalence of root caries decreased from 19% during 1988-1994 to 14% during 1999-2004, with the greatest decline in the 50- to 64-year age group. The prevalence of root caries was 8% in people aged 20 to 34, 14.8% in people aged 35 to 49, and 21.6% in people aged 50 to 64. In the case of root caries, there was also a difference based on gender, with men having more root caries (15.8%) than women (12.7%).

Mean DMFT and DMFS scores for adults were lower in 1999-2004. The authors of the NHANES study observed that one reason for this is increased tooth retention in adults since the 1988-1994 study period (see Table 1 for a comparison of DMFT and DMFS scores according to age, gender, and race). 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, while there were some differences in DMF scores based on race, they were not as significant as seen in children. Finally, there was also a difference in DMFT and DMFS scores between the genders: Women demonstrate higher scores compared to men of the same age, but this is not because women are more susceptible to dental caries. It is most likely due to the fact that women seek dental care more frequently than men, and women experience earlier tooth eruption patterns. However, recent papers in peer reviewed journals examined the gender differences and suggested several possibilities including a hereditary component for caries susceptibility carried on the X chromosome.13-15

Table 1. DMFT and DMFS scores in American adults in 1999−2004.
Group DMFT score DMFS score
Age: 20-34 6 13.4
Age: 35-49 10.9 31.5
Age: 50-64 15 53.9
Gender: Male 9.9 29.8
Gender: Female 10.7 32.1
Race: Non-Hispanic White 10.7 31.4
Race: African-American 9.8 31.9
Race: Mexican-American 8 24.1
Adapted from Dye BA, Tan S, Smith V, et al. Trends in oral health status, 1988 to 1994 and 1999 to 2004. National Center for Health Statistics. Vital Health Statistics. 2007; series 11(248).

In 2016, the Health Policy Institute of the American Dental Association (ADA) made available oral health fact sheets for every US state. These data can be accessed via the following ADA link:, and may be of interest to both dental health professionals and their patients.