NCHS Data Brief ■ No. 197 ■ May 2015

Dental Caries and Tooth Loss in Adults in the 

United States, 2011–2012

Bruce A. Dye, D.D.S., M.P.H.; Gina Thornton-Evans, D.D.S, M.P.H.; Xianfen Li, M.S.; and 

Timothy J. Iafolla, D.M.D., M.P.H.

Key findings

Data from the National 

Health and Nutrition 

Examination Survey, 

2011–2012

● Among adults aged 20–64, 

91% had dental caries and 27% 

had untreated tooth decay.

● Untreated tooth decay was 

higher for Hispanic (36%) and 

non-Hispanic black (42%) 

adults compared with nonHispanic white (22%) and 

non-Hispanic Asian (17%) 

adults aged 20–64.

● Adults aged 20–39 were 

twice as likely to have all their 

teeth (67%) compared with 

those aged 40–64 (34%).

● About one in five adults 

aged 65 and over had untreated 

tooth decay.

● Among adults aged 65 and 

over, complete tooth loss was 

lower for older Hispanic (15%) 

and non-Hispanic white (17%) 

adults compared with older 

non-Hispanic black adults 

(29%).

Dental caries and tooth loss are important oral health indicators for adults 

and are key measures for monitoring progress toward health promotion goals 

set by Healthy People 2020 (1,2). Although tooth decay and complete tooth 

loss have been declining in the United States since the 1960s, disparities have 

remained between some groups (3,4). As adults age, oral health-related quality 

of life is negatively affected by tooth loss and decay (5). This report describes 

U.S. adult dental caries and tooth loss by age and race and Hispanic origin for 

2011–2012.

Keywords: tooth decay • edentulism • disparities • NHANES

What percentage of adults had dental caries in permanent teeth?

Approximately 91% of U.S. adults aged 20–64 had dental caries in permanent 

teeth in 2011–2012 (Figure 1). Dental caries among adults aged 35–64 was 

Figure 1. Prevalence of dental caries in permanent teeth among adults aged 20–64, by age 

and race and Hispanic origin: United States, 2011–2012 

1

Includes untreated and treated (restored) dental caries.

2

Significantly different from ages 35–49, p < 0.05. 3

Significantly different from ages 50–64, p < 0.05. 4

Significantly different from non-Hispanic black adults, p < 0.05. 5

Significantly different from Hispanic adults, p < 0.05. 6

Significantly different from non-Hispanic Asian adults, p < 0.05.

NOTE: Access data table for Figure 1 at: http://www.cdc.gov/nchs/data/databriefs/db197_table.pdf#1.

SOURCE: CDC/NCHS, National Health and Nutrition Examination Survey, 2011–2012.

0 20 40 60

Percent

80 100

Non-Hispanic Asian

 Hispanic

Non-Hispanic black

Non-Hispanic white

50–64

35–49

20–34

Total

Untreated dental caries

Dental caries experience1

Non-Hispanic Asian

 Hispanic

Non-Hispanic black

Non-Hispanic white

50–64

35–49

20–34

Total 90.9 2,3 82.1

93.6

97.4 4,5,6 93.8

85.6

85.4

85.0

26.6

27.3

27.0

25.5 4,522.0

42.0

35.7 4,517.1

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics
NCHS Data Brief ■ No. 197 ■ May 2015

■  2  ■

higher (94%–97%) compared with adults aged 20–34 (82%). The prevalence of caries among 

adults aged 20–64 was lower for Hispanic (85%), non-Hispanic black (86%), and non-Hispanic 

Asian (85%) adults compared with non-Hispanic white adults (94%).

During 2011–2012, about 27% of adults aged 20–64 had untreated tooth decay in permanent 

teeth. Little difference was seen in the prevalence of untreated dental caries between the age 

groups examined. The prevalence of untreated dental caries was nearly twice as high for nonHispanic black adults (42%) compared with non-Hispanic white (22%) and Asian (17%) adults. 

Untreated tooth decay was lower among non-Hispanic white and Asian adults compared with 

Hispanic adults (36%).

What percentage of older adults had dental caries in permanent teeth?

In 2011–2012, nearly all U.S. adults aged 65 and over (96%) with any permanent teeth had dental 

caries (Figure 2). The prevalence of dental caries was similar among those aged 65–74 and those 

aged 75 and over. Caries prevalence was lower for non-Hispanic black (91%) and Hispanic (86%) 

adults compared with non-Hispanic white adults (98%).

Figure 2. Prevalence of dental caries in permanent teeth among adults aged 65 and over, by age and race and Hispanic 

origin: United States, 2011–2012 

1

Includes untreated and treated (restored) dental caries.

2

Significantly different from non-Hispanic black adults, p < 0.05. 3

Significantly different from Hispanic adults, p < 0.05. 4

Significantly different from non-Hispanic Asian adults, p < 0.05.

NOTE: Access data table for Figure 2 at: http://www.cdc.gov/nchs/data/databriefs/db197_table.pdf#2.

SOURCE: CDC/NCHS, National Health and Nutrition Examination Survey, 2011–2012.

0 20 40

Percent

60 80 100

Non-Hispanic Asian

 Hispanic

Non-Hispanic black

Non-Hispanic white

75 and over

65–74

Total

Non-Hispanic Asian

 Hispanic

Non-Hispanic black

Non-Hispanic white

75 and over

65–74

Total

Untreated dental caries

Dental caries experience1

96.2

96.0

96.6

2,397.8

90.5

86.1

92.0

18.9

18.5

19.4

2,3,415.5

40.9

2

26.7

2

27.3
NCHS Data Brief ■ No. 197 ■ May 2015

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Approximately 19% of adults aged 65 and over had untreated caries in 2011–2012. No difference 

was seen in untreated dental caries prevalence between those aged 65–74 and those aged 75 

and over. Untreated tooth decay was significantly higher for non-Hispanic black adults (41%) 

compared with Hispanic (27%), non-Hispanic white (16%), and non-Hispanic Asian (27%) 

adults. Older non-Hispanic Asian and Hispanic adults were more likely to have untreated dental 

caries compared with older non-Hispanic white adults.

What percentage of adults had no loss of permanent teeth?

Forty-eight percent of adults aged 20–64 had a full set of permanent teeth (excluding third 

molars) (Figure 3). Twice as many adults aged 20–39 (67%) had retained all of their permanent 

teeth compared with adults aged 40–64 (34%). Tooth retention was lower among non-Hispanic 

black adults (38%) compared with non-Hispanic white (51%), non-Hispanic Asian (49%), and 

Hispanic (45%) adults. Hispanic adults also were less likely to have retained all of their teeth 

compared with non-Hispanic white adults. No difference was noted between men and women in 

the percentage of adults experiencing no tooth loss due to dental disease. Percent

Figure 3. Prevalence of permanent tooth retention among adults aged 20–64, by age, sex, and race and Hispanic origin: 

United States, 2011–2012 

1

Significantly different from ages 40–64, p < 0.05. 2

Significantly different from non-Hispanic black adults, p < 0.05. 3

Significantly different from Hispanic adults, p < 0.05. 

NOTE: Access data table for Figure 3 at: http://www.cdc.gov/nchs/data/databriefs/db197_table.pdf#3.

SOURCE: CDC/NCHS, National Health and Nutrition Examination Survey, 2011–2012.

0

20

40

60

80

NonHispanic

Asian

Non- Hispanic

Hispanic 

black

NonHispanic

white

Total 20–39 40–64 Men Women

48.2

1

66.7

33.6

48.5 48.0

2,351.0

37.5

2

44.9

2

49.0
NCHS Data Brief ■ No. 197 ■ May 2015

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How prevalent was complete tooth loss (edentulism) among older adults?

Nearly 19% of adults aged 65 and over were edentulous in 2011–2012 (Figure 4). Edentulism 

was twice as prevalent among adults aged 75 and over (26%) compared with adults aged 65–74 

(13%). More non-Hispanic black adults aged 65 and over were edentulous (29%) compared with 

non-Hispanic white (17%) and Hispanic (15%) adults. Although the prevalence of complete tooth 

loss was higher among older non-Hispanic Asian adults (24%) compared with older Hispanic 

and non-Hispanic white adults, this difference was not statistically significant. The prevalence of 

edentulism was similar between men (18%) and women (19%). Percent

Figure 4. Prevalence of complete tooth loss (edentulism) among adults aged 65 and over, by age, sex, and race and 

Hispanic origin: United States, 2011–2012

1

Significantly different from ages 75 and over, p < 0.05. 2

Significantly different from non-Hispanic black adults, p < 0.05.

NOTE: Access data table for Figure 4 at: http://www.cdc.gov/nchs/data/databriefs/db197_table.pdf#4.

SOURCE: CDC/NCHS, National Health and Nutrition Examination Survey, 2011–2012.

NonHispanic

Asian

Non- Hispanic

Hispanic 

black

NonHispanic

white

75 and Men Women

over

Total 65–74

18.6

1

13.0

25.8

17.5

19.4

2

16.9

29.2

2

14.9

24.2

0

5

10

15

20

25

30

35
NCHS Data Brief ■ No. 197 ■ May 2015

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Summary

Disparities by age and race and Hispanic origin for dental caries and tooth loss existed among 

U.S. adults in 2011–2012. For adults aged 20–64, dental caries was lower for Hispanic, nonHispanic black, and non-Hispanic Asian adults compared with non-Hispanic white adults, 

whereas untreated tooth decay was more prevalent among Hispanic and non-Hispanic black 

adults compared with non-Hispanic white and Asian adults. Nine of 10 adults aged 20–64 had 

dental caries, and caries experience was more prevalent among adults aged 35–64 than among 

younger adults. In contrast, a little more than one-quarter of adults aged 20–64 (27%) had 

untreated tooth decay, and the prevalence of untreated caries did not vary as adults aged. 

About one-half of adults aged 20–64 living in the United States had not lost a tooth in 2011–2012. 

Tooth retention was twice as prevalent among adults aged 20–39 compared with those aged 

40–64. Non-Hispanic black adults were more likely to have lost one or more teeth compared with 

Hispanic, non-Hispanic white, and non-Hispanic Asian adults.

Oral health disparities by age and race and Hispanic origin also existed for older adults in 2011–

2012. Although nearly all adults over age 65 had experienced dental caries, caries prevalence 

was higher among older non-Hispanic white adults compared with older non-Hispanic black and 

Hispanic adults. However, in this age group, non-Hispanic black adults were more likely to have 

untreated tooth decay compared with Hispanic, non-Hispanic white, and non-Hispanic Asian 

adults.

Overall, 19% of adults aged 65 and over were edentulous in 2011–2012. Edentulism was twice 

as prevalent among adults aged 75 and over compared with those aged 65–74. Although little 

difference was seen in the prevalence of edentulism between men and women, differences by race 

and Hispanic origin for complete tooth loss did exist in 2011–2012. Older non-Hispanic black 

adults were more likely to be edentulous compared with older non-Hispanic white or Hispanic 

adults, and nearly one in four older non-Hispanic Asian adults were edentulous in 2011–2012.

Definitions

Untreated dental caries: Dental cavities (tooth decay) that have not received appropriate 

treatment.

Dental caries: Having a tooth appropriately treated for tooth decay or having untreated decay 

present.

Tooth retention: Having all natural permanent teeth present, excluding third molars.

Edentulism: Having all natural permanent teeth missing, including third molars.

Data source and methods

Data from the National Health and Nutrition Examination Survey (NHANES) were used to 

produce this report. NHANES is a cross-sectional survey designed to monitor the health and 

nutritional status of the civilian noninstitutionalized U.S. population. Survey participants are 

selected through a complex, multistage process that includes oversampling in order to obtain 

reliable estimates of health and nutritional measures for population subgroups. In 2011–2012, 
NCHS Data Brief ■ No. 197 ■ May 2015

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oversampling included Hispanic, non-Hispanic black, and non-Hispanic Asian persons. The 

survey consists of interviews conducted in participants’ homes and standardized physical 

examinations in mobile examination centers (MECs). Additional information on NHANES is 

available from: http://www.cdc.gov/nchs/nhanes.htm.

From 2011 through 2012, the NHANES oral health assessment was conducted in MECs by 

trained dentists. The assessment included a tooth count to identify the presence or absence of 

permanent or primary teeth, including retained dental root tips and dental implants. Each tooth 

surface was assessed for dental caries and restorations. Dental examinations were conducted 

using a dental light for illumination, a dental mirror, and an explorer. Overall, preliminary data 

reliability analyses conducted for 2011–2012 indicate that examiner performance was similar to 

prior survey periods (1999–2004) using the same dental caries examination methods.

Population estimates and standard errors were calculated in SAS-callable SUDAAN software 

release 11.0 (RTI International, Research Triangle Park, N.C.). Examination sample weights to 

account for differing probabilities of selection, nonresponse, and noncoverage were used for 

analysis. The standard errors of the percentages were estimated using Taylor series linearization, 

to take into account the complex sampling design. Differences between groups were evaluated 

using a t statistic at the p < 0.05 significance level. All results presented have a relative standard 

error less than 30%. All differences discussed are statistically significant unless otherwise 

indicated. Calculated estimates were not age-adjusted, and no adjustments were made for multiple 

comparisons.

About the authors

Bruce A. Dye is with the National Institutes of Health’s (NIH) National Institute of Dental and 

Craniofacial Research. Gina Thornton-Evans is with CDC’s National Center for Chronic Disease 

Prevention and Health Promotion, Division of Oral Health. Xianfen Li is with CDC’s National 

Center for Health Statistics, Office of Analysis and Epidemiology. Timothy J. Iafolla is with 

NIH’s National Institute of Dental and Craniofacial Research.
NCHS Data Brief ■ No. 197 ■ May 2015

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References

1. HHS. Healthy People 2020. Available from: http://www.healthypeople.gov.

2. HHS. Oral health in America: A report of the surgeon general. 2000. Available from: 

http://silk.nih.gov/public/hck1ocv.@www.surgeon.fullrpt.pdf. 

3. Dye BA, Tan S, Smith V, et al. Trends in oral health status—United States, 1988–1994 and 

1999–2004. National Center for Health Statistics. Vital Health Stat 11(248). 2007.

4. Dye BA, Li X, Beltrán-Aguilar ED. Selected oral health indicators in the United States, 

2005–2008. NCHS data brief, no 96. Hyattsville, MD: National Center for Health Statistics. 2012.

5. Thomson WM. Epidemiology of oral health conditions in older people. Gerodontology 31 

Suppl 1:9–16. 2014.
NCHS Data Brief ■ No. 197 ■ May 2015

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Suggested citation

Dye BA, Thornton-Evans G, Li X, Iafolla 

TJ. Dental caries and tooth loss in adults in 

the United States, 2011–2012. NCHS data 

brief, no 197. Hyattsville, MD: National 

Center for Health Statistics. 2015.

Copyright information

All material appearing in this report is in 

the public domain and may be reproduced 

or copied without permission; citation as to 

source, however, is appreciated.

National Center for Health 

Statistics

Charles J. Rothwell, M.S., M.B.A., Director

Nathaniel Schenker, Ph.D., Deputy Director

Jennifer H. Madans, Ph.D., Associate 

Director for Science

Division of Health and Nutrition 

Examination Surveys

Kathryn S. Porter, M.D., M.S., Director

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