Caries in Children and Adolescents in the United States

Children between the ages of 2 and 19 were included in this group. Overall, it was seen that in children over 5, there was a decrease in dental caries prevalence. On the other hand, there was an increase in caries prevalence in children between 2 and 5.

While there is a decrease in caries prevalence overall, it was noted that children are more likely to get caries as they age: In the 1999 to 2004 period, 75.8% of the children aged 2 to 5 years were caries-free and corresponding percentages for children aged 6 to 11 years, 12 to 15 years and 16 to 19 years were 50.1%, 42.7% and 21.8%, respectively. The proportion of children with dental restorations also increased with age: In the 2005 to 2008 period, 38.7% of the children aged 5 to 11 years had dental restoration while the percentage for children aged 12 to 19 years was 52.0%.

Some of the most noteworthy data were found in the 2- to 11-year-old age group when comparing the 1988–1994 and 1998–2004 data. In this age group, the prevalence of untreated tooth decay was found to remain stable at approximately 23%, but the mean number of decayed and filled primary teeth (dft) significantly increased from 1.39 to 1.58. This increase seems to be due primarily to increases in dental caries in the youngest age group—the 2- to 5-year-olds. When examined further, this increase in caries in 2- to 5-year-olds was not linked to an increase in untreated decay, but to an increase in the number of restored dental surfaces. This suggests that the observed increase in dft scores in primary teeth may be the result of more restorative treatment in young children.

Also of note was the link between children’s df scores and poverty. The highest d and f scores were in children living under the Federal Poverty Line (FPL). These numbers increased between 1988-1994 and 1999-2004, suggesting less access to dental care in low-income families over time. Mean dfs scores also tended to peak earlier in age for children living under the FPL, compared to children living in families with incomes that are equal to or greater than the FPL. In addition, in 1999-2004, levels of untreated decay were highest in children living below the FPL: 33% compared to 28% of children living at, or up to twice the FPL, and 15% of children living at greater than twice the FPL.

There was also a link between levels of untreated decay and race. For example, in children under 11, 33% of Mexican-American children had untreated decay, compared to 28% of African-American children and 19% of non-Hispanic white children.