Introduction

Dental caries, or tooth decay, is a common chronic disease that can cause pain, suffering, and diminished quality of life throughout one’s lifespan.¹ Left untreated, tooth decay can progress and lead to infection, tooth loss, and more complex and expensive treatments. Untreated tooth decay can affect essential aspects of daily living, including eating, speaking, and performing at home, school, or work.¹ Children with poor oral health miss more school and receive lower grades than those with better oral health, while adults lose more school or work hours for urgent, unplanned dental visits.^2–4

The National Health and Nutrition Examination Survey (NHANES) provides information to monitor the overall prevalence and severity of oral diseases,^5–12 the extent of health disparities,^13–15 and the prevalence of preventive interventions, such as dental sealants. Dental sealants are professionally applied coatings that prevent decay in the chewing surfaces of the molar teeth.¹⁶ NHANES data are used by health agencies and organizations, health care providers, and researchers to guide the development of public health policy, direct public health practice, and expand health knowledge in the United States.¹⁷

Compared with NHANES 1988–1994, findings from NHANES 1999–2004 showed that the percentage of children aged 6–11 years and adolescents aged 12–19 years with dental caries in their permanent teeth had decreased to about 20% and 60%, respectively, whereas the percentage with untreated decay remained unchanged at about 8% and 20%.^6,10 These findings suggest a decrease in receipt of fillings (i.e., restorations).

Among young children aged 2–5 years, the prevalence of caries in primary teeth increased 4 percentage points to 28%, with no change in untreated decay.^10,18 This finding suggests an increase in restorations. The prevalence of dental sealants in permanent teeth increased by almost 10 percentage points to 30% among children aged 6–11 years and by 20 percentage points to almost 40% among adolescents aged 12–19 years. Adults and older adults were keeping more of their teeth, and the percentage who had lost all their teeth had declined.^10,19 These findings highlight overall improvements in oral health across the US population and across the life span by 1999–2004. However, disparities continued by poverty status, education, and race or ethnicity.¹⁰