NCHS Data Brief ■ No. 368 ■ June 2020

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics

Prevalence of Tooth Loss Among Older 

Adults: United States, 2015–2018

Eleanor Fleming, Ph.D., D.D.S., M.P.H., Joseph Afful, M.S., and Susan O. Griffin, Ph.D.

Key findings

Data from the National 

Health and Nutrition 

Examination Survey

● Prevalence of complete tooth 

loss among adults aged 65 and 

over was 12.9% and increased 

with age: 8.9% (ages 65–69), 

10.6% (ages 70–74), and 17.8% 

(ages 75 and over).

● Non-Hispanic black older 

adults (25.4%) had a higher 

prevalence of complete tooth 

loss than Hispanic (15.3%) and 

non-Hispanic white (10.9%) 

older adults. 

● Prevalence of complete tooth 

loss was higher for older adults 

with less than a high school 

education (31.9%) compared 

with those with a high school 

education or greater (9.5%).

● From 1999–2000 through 

2017–2018, the age-adjusted 

prevalence of complete tooth 

loss among all older adults 

declined significantly.

Complete tooth loss can diminish quality of life, limiting food choices and 

impeding social interaction (1). Reducing complete tooth loss is a national 

health goal monitored by Healthy People; although prevalence has decreased 

since the 1960s, disparities persist (2–4). Factors leading to complete tooth 

loss—untreated dental caries, periodontitis, and smoking—are preventable and 

differ by socioeconomic status and between men and women (5,6). This report 

examines disparities in complete tooth loss among U.S. adults aged 65 and 

over by sex, age, race and Hispanic origin, and education in 2015–2018 and 

trends from 1999–2000 through 2017–2018.

What was the prevalence of complete tooth loss among 

older adults in 2015–2018?

The prevalence of complete tooth loss among adults aged 65 and over was 

12.9% in 2015–2018 (Figure 1). Prevalence increased with age, overall (8.9% 

Figure 1. Prevalence of complete tooth loss among adults aged 65 and over, by sex and age: 

United States, 2015–2018

1Significant linear trend with increasing age.

2Significant difference from men aged 75 and over.

NOTE: Access data table for Figure 1 at: https://www.cdc.gov/nchs/data/databriefs/db368-tables-508.pdf#1.

SOURCE: NCHS, National Health and Nutrition Examination Survey, 2015–2018. Percent

All Men Women

20

15

10

5

0

65 and over 65–69 70–74 75 and over

12.9

18.9

10.6

17.8

13.8

211.1

29.4

19.5

12.2

16.9

11.7

16.6

NCHS reports can be downloaded from: https://www.cdc.gov/nchs/products/index.htm.
NCHS Data Brief ■ No. 368 ■ June 2020

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for adults aged 65–69, 10.6% for ages 70–74, and 17.8% for ages 75 and over) and among 

women (6.9% for ages 65–69, 11.7% for ages 70–74, and 16.6% for ages 75 and over). Among 

men, complete tooth loss was higher in the oldest age group (19.5% for 75 and over) compared 

with the two younger groups (11.1% and 9.4%, respectively, for those aged 65–69 and 70–74). 

No significant differences in prevalence between men and women were observed. 

What were the differences in the prevalence of complete tooth loss among 

older adults by race and Hispanic origin in 2015–2018?

Overall, the prevalence of complete tooth loss was significantly higher among non-Hispanic 

black older adults (25.4%) compared with Hispanic (15.3%) and non-Hispanic white (10.9%) 

older adults (Figure 2). 

Among men, prevalence was also higher among non-Hispanic black men (23.4%) compared with 

non-Hispanic white (12.5%) and Hispanic (11.9%) men. Among women, prevalence of complete 

tooth loss was higher in non-Hispanic black women (26.8%) compared with Hispanic (17.8%) 

and non-Hispanic white (9.5%) women. Prevalence was also higher among Hispanic women 

compared with non-Hispanic white women.

Among Hispanic older adults, prevalence of complete tooth loss was higher among women 

than in men.

Figure 2. Prevalence of complete tooth loss among adults aged 65 and over, by sex and race and Hispanic origin: 

United States, 2015–2018

1Significant difference from non-Hispanic black persons.

2Significant difference from Hispanic persons.

3Significant difference from Hispanic men.

NOTE: Access data table for Figure 2 at: https://www.cdc.gov/nchs/data/databriefs/db368-tables-508.pdf#2.

SOURCE: NCHS, National Health and Nutrition Examination Survey, 2015–2018.

Non-Hispanic white Non-Hispanic black Hispanic

Percent

All Men Women

30

20

10

0

110.9

25.4

115.3

112.5

23.4

111.9

1,29.5

26.8

1,317.8
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What were the differences in the prevalence of complete tooth loss among 

older adults by education level in 2015–2018?

In 2015–2018, the prevalence of complete tooth loss among older adults was higher among 

adults with less than a high school education (31.9%) compared with adults with a high school 

education or greater (9.5%) (Figure 3). Similarly, the prevalence of complete tooth loss was 

35.4% among men with less than a high school education and 10.1% among men with a high 

school education or greater. For women, the prevalence of complete tooth loss was 29.3% among 

those with less than a high school education and 9.0% among those with a high school education 

or greater. No significant differences were noted by education level between men and women. 

Figure 3. Prevalence of complete tooth loss among adults aged 65 and over, by education level: United States, 

2015–2018 

1Significant difference from adults with a high school education or greater.

NOTE: Access data table for Figure 3 at: https://www.cdc.gov/nchs/data/databriefs/db368-tables-508.pdf#3.

SOURCE: NCHS, National Health and Nutrition Examination Survey, 2015–2018.

Less than high school education High school education or greater

Percent

All Men Women

40

30

20

10

0

131.9

9.5

135.4

10.1

129.3

9.0
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What were the age-adjusted trends in complete tooth loss among older 

adults from 1999–2000 through 2017–2018?

From 1999–2000 through 2017–2018, the age-adjusted prevalence of complete tooth loss 

decreased from 29.9% to 13.1% (Figure 4). Prevalence also decreased among men from 25.5% to 

13.8% and among women from 33.1% to 12.5%. In 1999–2000, 2003–2004, and 2005–2006 the 

prevalence was higher among women than men, while in later years, no significant differences 

were seen between men and women.

Figure 4. Trends in prevalence of complete tooth loss among adults aged 65 and over, by sex: United States, 1999–2000 

through 2017–2018

1Significant, decreasing linear trend from 1999–2000 to 2017–2018. 

2Significant difference from men for 1999–2000, 2003–2004, and 2005–2006.

NOTES: Estimates were age adjusted by the direct method to the 2000 U.S. Census population using the age groups 65–69, 70–74, and 75 and over. Access data 

table for Figure 4 at: https://www.cdc.gov/nchs/data/databriefs/db368-tables-508.pdf#4.

SOURCE: NCHS, National Health and Nutrition Examination Survey, 1999–2018. 

Survey period

Percent

30

35

20

25

10

15

0

5

1999–

2000

2001–

2002

2003–

2004

2005–

2006

2007–

2008

2009–

2010

2011–

2012

2013–

2014

2015–

2016

2017–

2018

Men1

Women1,2

All1
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Summary

In 2015–2018, the prevalence of complete tooth loss was 12.9% among adults aged 65 and over 

and increased with age. Non-Hispanic black older adults had the highest prevalence of complete 

tooth loss (25.4%) compared with other race and Hispanic-origin groups. The only statistically 

significant difference between men and women was among Hispanic adults, where the prevalence 

was higher among women compared with men. The prevalence of complete tooth loss among 

older adults was higher among adults with less education. 

From 1999–2000 through 2017–2018, the age-adjusted prevalence of complete tooth loss 

declined. This pattern is consistent with previous reports of greater percentages of older adults 

retaining their natural teeth (7). Improved diagnostic tools and restorative treatment modalities 

like fillings and fixed restorations along with prevention efforts may have resulted in a lower 

prevalence of complete tooth loss among adults aged 65 and over (1,7). 

Definitions

Complete tooth loss: The loss of all natural, permanent teeth.

Education level: Based on an individual’s highest level of education, categorized as less than a 

high school education and a high school education or greater.
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Data source and methods

The National Health and Nutrition Examination Survey (NHANES) is a cross-sectional survey 

conducted by the National Center for Health Statistics (NCHS) designed to monitor the health and 

nutritional status of the civilian noninstitutionalized U.S. population (8). The survey consists of 

home interviews, followed by standardized physical examinations in mobile examination centers. 

NHANES includes an oral health examination that involves a tooth count assessment. Trained, 

licensed dentists conduct the oral health examination, assessing the presence of a tooth, whether 

it is a permanent or primary tooth, and if a root tip is present (9). Tooth count assessments were 

used in this analysis. Dental examiners followed the same protocol for 1999–2004 and 2011–2018 

(9). A basic screening examination methodology was used to conduct the oral health examination 

in 2005–2010; health technologists conducted the oral health examination in 2005–2008, and 

licensed dental hygienists conducted the examination in 2009–2010 (10). 

The NHANES sample is selected through a complex, multistage probability design. In 

2015–2018, non-Hispanic black, non-Hispanic Asian, and Hispanic persons were oversampled; 

for more information, visit the NHANES website: https://www.cdc.gov/nchs/nhanes/index.htm. 

Examination weights were used to account for the differential probabilities of selection, 

nonresponse, and noncoverage. Taylor series linearization was used to compute variance 

estimates. Differences between groups were evaluated using a univariate t statistic at the p less 

than 0.05 significance level. All reported estimates meet NCHS presentation standards (11). 

Linear regression modeling was used to determine the significance of linear trends. Age-adjusted 

prevalence estimates were used in the time trend analysis. Age-adjustments were done using the 

direct method to the 2000 projected U.S. Census population using the age groups 65–69, 70–74, 

and 75 and over. Statistical analyses were conducted using SAS for Windows version 9.4 (SAS 

Institute, Inc., Cary, N.C.) and SAS-callable SUDAAN version 11.0 (RTI International, Research 

Triangle Park, N.C.).

About the authors

Eleanor Fleming is with NCHS’ Division of Health and Nutrition Examination Surveys. Joseph 

Afful is with Peraton Corporation. Susan O. Griffin is with the National Center for Chronic 

Disease Prevention and Health Promotion, Division of Oral Health.
NCHS Data Brief ■ No. 368 ■ June 2020

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References

1. National Institute of Dental and Craniofacial Research, National Institutes of Health. 

Oral health in America: A report of the Surgeon General. 2000.

2. U.S. Department of Health and Human Services. Healthy People 2020: Oral health. 2019. 

Available from: https://www.healthypeople.gov/2020/topics-objectives/topic/oral-health.

3. Gooch BF, Eke PI, Malvitz DM. Public health and aging: Retention of natural teeth among 

older adults—United States, 2002. MMWR Morb Mortal Wkly Rep 52(50):1226–9. 2003.

4. Centers for Disease Control and Prevention. Oral health surveillance report: Trends in dental 

caries and sealants, tooth retention, and edentulism, United States, 1999–2004 to 2011–2016. 

2019. Available from: https://www.cdc.gov/oralhealth/publications/OHSR-2019-

index.html.

5. Eke PI, Dya BA, Wei L, Slade GD, Thornton-Evans GO, Borgnakke WS, et al. Update on 

prevalence of periodontitis in adults in the United States: NHANES 2009 to 2012. J Periodontol 

86(5):611–22. 2015.

6. Centers for Disease Control and Prevention. Current cigarette smoking among adults in the 

United States. 2019. Available from: https://www.cdc.gov/tobacco/data_statistics/fact_sheets/

adult_data/cig_smoking/index.htm. 

7. Griffin SO, Griffin PM, Li CH, Bailey WD, Brunson D, Jones JA. Changes in older adults’ 

oral health and disparities: 1999 to 2004 and 2011 to 2016. J Am Geriatr Soc 67(6):1152–7. 2019.

8. Johnson CL, Dohrmann SM, Burt VL, Mohadjer LK. National Health and Nutrition 

Examination Survey: Sample design, 2011–2014. National Center for Health Statistics. 

Vital Health Stat 2(162). 2014. 

9. National Center for Health Statistics. NHANES questionnaires, datasets, and related 

documentation. Continuous NHANES: 2011–2012, 2013–2014, 2015–2016. Available from: 

https://wwwn.cdc.gov/nchs/nhanes/default.aspx.

10. National Center for Health Statistics. NHANES questionnaires, datasets, and related 

documentation. Continuous NHANES: 2005–2006, 2007–2008, 2009–2010. Available from: 

https://wwwn.cdc.gov/nchs/nhanes/default.aspx.

11. Parker JD, Talih M, Malec DJ, Beresovksy V, Carroll M, Gonzalez JF Jr, et al. National 

Center for Health Statistics data presentation standards for proportions. National Center for 

Health Statistics. Vital Health Stat 2(175). 2017.
NCHS Data Brief ■ No. 368 ■ June 2020

Keywords: oral health • NHANES Suggested citation

Fleming E, Afful J, Griffin SO. Prevalence 

of tooth loss among older adults: United 

States, 2015–2018. NCHS Data Brief, no 

368. Hyattsville, MD: National Center for 

Health Statistics. 2020.

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

Brian C. Moyer, Ph.D., Director

Amy M. Branum, Ph.D., Acting Associate 

Director for Science

Division of Health and Nutrition 

Examination Surveys

Ryne Paulose-Ram, M.A., Ph.D., Acting 

Director

Lara J. Akinbami, M.D., Acting Associate 

Director for Science

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