Dental Caries Among Adults and Older Adults

Adults Aged 20–64 Years

The prevalence of dental caries among adults aged 20–64 years was 90%, which is a slight decrease from 92% during 1999– 2004 (Table 25). Decreases of 2 to 4 percentage points were observed among adults who were younger (aged 20–34 and 35–49 years), male, non-Hispanic white, not-poor, and better educated and who had never or formerly smoked.

Overall, the prevalence of untreated tooth decay was 26% (Table 26). No changes were detected overall or across sociodemographic characteristics since 1999–2004, with the exception of current or former smokers and adults with a high school education, all of whom experienced a 5 percentage point increase. During 2011–2016, the prevalence of untreated decay was almost 40% to 50% among adults who were non- Hispanic black, Mexican American, or poor and near-poor combined; who had a high school education or lower; and who were current smokers. Prevalence among these groups was about twice that of adults who were non-Hispanic white or not- poor, who had more than a high school education, and who had never smoked. Prevalence of untreated decay was higher among younger adults aged 20–34 years (29%) than among adults aged 35–49 years (26%) or 50–64 years (22%).

Among adults with caries, mean DFT was 7.4, lower than the estimate of 8.2 during 1999–2004 (Table 27). Mean DFT and FT both decreased by about 1 tooth overall and among adults who were aged 35–49 or 50–64 years, male, female, non- Hispanic white, or not-poor; who had a high school education or more; and who were current, former, or never smokers.

No changes were detected in mean DT overall or across sociodemographic characteristics, except for slight increases among adults who had a high school education or more and were former smokers. Overall, no change was detected in the mean percentage of caries that were untreated (% DT/DFT), which was 16% during 2011–2016 (Table 28). However, increases in mean % DT/DFT of 3 to 5 percentage points were seen among current and former smokers and those with a high school education or more.

During 2011–2016, adults who were younger (aged 20–34 years), male, non-Hispanic black, Mexican American, or poor and near-poor combined; who had a high school education or less; and who were current smokers had higher DT (1.1–1.8) and lower FT (4.5–6.0) than their respective reference groups within each sociodemographic characteristic, with DT ranging from 0.6 to 0.9 and FT ranging from 6.6 to 8.3 (Table 27).

Similar comparisons showed that, for these same groups, the mean percentage of teeth with caries that were untreated (% DT/DFT) was higher than their respective reference groups, whereas the mean percentage that were filled (% FT/DFT) was lower (Table 28). The mean % DT/DFT of about 24% to 34% among adults who were non-Hispanic black, Mexican American, or poor and near-poor combined; who had a high school education or less; and who were current smokers was 2 to 3 times that of their respective reference groups within each sociodemographic characteristic.

Older Adults Aged 65 Years or Older

The prevalence of dental caries among adults aged 65 years or older was 96%, showing an overall increase of 3 percentage points since 1999–2004 (Table 29). For most sociodemographic groups, increases in caries prevalence ranged from 3 to 5 percentage points. No group experienced a statistically significant decrease. During 2011–2016, prevalence among older adults who were non-Hispanic white or not-poor, who had more than a high school education, and who were former smokers or never smoked ranged from 96% to 98%, which is higher than estimates of 85% to 95% for their respective counterparts within each sociodemographic characteristic. The estimates of prevalence across all sociodemographic groups were at or above 85%.

The prevalence of untreated tooth decay among adults aged 65 years or older was 16%, with no detectable change during 1999–2004 (Table 30). Except for a decrease of 4 percentage points in not-poor older adults, no differences in prevalence were detected for any other sociodemographic group between the two survey periods. During 2011–2016, however, the prevalence of untreated decay among older adults who were Mexican American, non-Hispanic black, or poor and near-poor combined; who had less than a high school education; and who were current smokers ranged from 29% to 36%, higher than the estimates of 10% to 14% for their respective reference groups within each sociodemographic characteristic.

The mean DFT among adults aged 65 years or older was 10, an increase of 1 tooth during 1999–2004 (Table 31). Increases in DFT between the two survey periods were similar to increases in FT overall and among adults who were aged 65–74 years or 75 years or older, male, non-Hispanic white, non-Hispanic black, not-poor, and former smokers. Small decreases in mean DT were found overall (0.1 teeth) and among those who were aged 75 years or older (0.2), non-Hispanic black (0.4), and not-poor (0.1).

Overall, the mean percentage of teeth with caries that were untreated (% DT/DFT) decreased from 9% during 1999–2004 to 7% during 2011–2016 (Table 32). Decreases of 2 to 3 percentage points in mean % DT/DFT were found among those who were aged 65–74 years, male, female, non-Hispanic white, or not-poor and who had never smoked. Corresponding increases were found in the mean percentage of teeth that were restored (% FT/DFT). Non-Hispanic black older adults had the largest decrease in mean % DT/DFT (11 percentage points) and a corresponding increase in % FT/DFT between the two survey periods.

During 2011–2016, mean DFT and FT were lower and mean DT was higher among older adults who were non-Hispanic black, Mexican American, or poor and near-poor combined; who had less than a high school education; and who were current smokers. Among these groups, mean DFT ranged from 5.1 to 7.5, mean FT from 4.4 to 6.8, and mean DT from 0.7 to 1.0,  compared to the reference group within each sociodemographic characteristic, which had mean DFT ranging from 10.4 to 11.5, mean FT ranging from 10.1 to 11.3, and mean DT ranging from 0.2 to 0.3 (Table 31). Similarly, the mean percentage of teeth with caries that were untreated (% DT/DFT) was higher among these groups (16%–29%) compared to their respective reference groups (3%–6%) (Table 32).