NCHS Data Brief ■ No. 307 ■ April 2018

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics

Prevalence of Total and Untreated Dental Caries Among 

Youth: United States, 2015–2016

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

Key findings 

Data from the National 

Health and Nutrition 

Examination Survey

● For 2015–2016, prevalence 

of total caries (untreated 

and treated) was 43.1% and 

untreated caries was 13.0% 

among youth aged 2–19 years.

● Prevalence was lowest in 

youth aged 2–5 years compared 

with those aged 6–11 and 

12–19 for total (17.7%, 45.2%, 

53.5%) and untreated caries 

(8.8%, 15.3%, 13.4%). 

● Hispanic youth had 

the highest prevalence of 

total caries; non-Hispanic 

black youth had the highest 

prevalence of untreated caries. 

● For both total and untreated 

caries, prevalence decreased as 

family income level increased.

● Total caries prevalence 

declined from 2011–2012 

(50.0%) to 2015–2016 (43.1%). 

For untreated caries, prevalence 

increased from 2011–2012 

(16.1%) to 2013–2014 

(18.0%), and then decreased in 

2015–2016 (13.0%). 

Dental caries is the most common chronic disease among youth aged 6–19 

years (1). Untreated caries can cause pain and infections (2,3). Monitoring 

prevalence of untreated and total caries (untreated and treated) is key to 

preventing and controlling oral diseases. This report presents the prevalence 

of total and untreated caries in primary or permanent teeth among youth aged 

2–19 years for 2015–2016, and trends from 2011–2012 through 2015–2016.

Keywords: tooth decay • dental cavity • caries experience • NHANES

What was the prevalence of total and untreated dental caries 

in youth for 2015–2016?

The prevalence of total dental caries (untreated and treated) in primary 

or permanent teeth among youth aged 2–19 years was 43.1% (Figure 1). 

Prevalence increased with age, going from 17.7% among youth aged 2–5 to 

45.2% among those aged 6–11 to 53.5% among those aged 12–19.

Figure 1. Prevalence of total dental caries and untreated dental caries in primary or permanent 

teeth among youth aged 2–19 years, by age: United States, 2015–2016

1

Significantly different from youth aged 2–5 years.

2

Significant linear trend with increasing age.

NOTES: Total dental caries include untreated and treated caries. Access data table for Figure 1 at:

https://www.cdc.gov/nchs/data/databriefs/db307_table.pdf#1.

SOURCE: NCHS, National Health and Nutrition Examination Survey, 2015–2016.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 
NCHS Data Brief ■ No. 307 ■ April 2018

The prevalence of untreated caries in primary or permanent teeth among youth aged 2–19 years 

was 13.0%. The prevalence among youth aged 2–5 (8.8%) was lower than it was among youth 

aged 6–11 (15.3%) and 12–19 (13.4%).

Did the prevalence of total and untreated dental caries differ among youth 

by race and Hispanic origin for 2015–2016?

Among youth aged 2–19 years, the prevalence of total dental caries was highest for Hispanic 

youth (52.0%) compared with non-Hispanic black (44.3%), non-Hispanic Asian (42.6%), and 

non-Hispanic white (39.0%) youth (Figure 2). However, the difference between the prevalence 

for Hispanic youth and non-Hispanic black youth did not reach statistical significance.

The prevalence of untreated dental caries was highest among non-Hispanic black (17.1%) 

youth compared with Hispanic (13.5%), non-Hispanic white (11.7%), and non-Hispanic Asian 

(10.5%) youth. However, the difference between the prevalence for non-Hispanic black youth and 

Hispanic youth did not reach statistical significance. 

Figure 2. Prevalence of total dental caries and untreated dental caries in primary or permanent teeth among youth aged 

2–19 years, by race and Hispanic origin: United States, 2015–2016

1

Significantly different from non-Hispanic white youth.

2

Significantly different from non-Hispanic Asian youth.

NOTES: Total dental caries include untreated and treated caries. Access data table for Figure 2 at: https://www.cdc.gov/nchs/data/databriefs/db307_table.pdf#2. 

SOURCE: NCHS, National Health and Nutrition Examination Survey, 2015–2016.

 

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NCHS Data Brief ■ No. 307 ■ April 2018

Were there differences in the prevalence of total and untreated dental 

caries among youth by income level for 2015–2016?

The prevalence of total dental caries decreased as family income levels increased, from 51.8% for 

youth from families living below the federal poverty level to 34.2% for youth from families with 

income levels greater than 300% of the federal poverty level (Figure 3). 

The prevalence of untreated dental caries decreased from 18.6% for youth from families living 

below the federal poverty level to 7.0% for youth from families with incomes greater than 300% 

of the federal poverty level. 

Figure 3. Prevalence of total dental caries and untreated dental caries in primary or permanent teeth among youth aged 

2–19 years, by federal poverty level: United States, 2015-2016

1

Significant decreasing linear trend.

NOTES: Total dental caries include untreated and treated caries. Access data table for Figure 3 at: https://www.cdc.gov/nchs/data/databriefs/db307_table.pdf#3. 

SOURCE: NCHS, National Health and Nutrition Examination Survey, 2015–2016.

 

 

 

 

 

 

 

 

 

 

 

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NCHS Data Brief ■ No. 307 ■ April 2018

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What are the trends in total and untreated dental caries in youth from

2011–2012 through 2015–2016?

A significant linear decrease was seen in the prevalence of total dental caries (from 50.0% to 

43.1%) in youth from 2011–2012 through 2015–2016. 

For untreated dental caries, the prevalence was 16.1% for 2011–2012, with the percentage 

increasing to 18.0% for 2013–2014, and then declining to 13.0% for 2015–2016 (Figure 4). 

Figure 4. Trends in prevalence of total dental caries and untreated dental caries in primary or permanent teeth among 

youth aged 2–19 years: United States, 2011–2012 through 2015–2016

1

Significant decreasing linear trend from 2011–2012 to 2015–2016.

2

Significant quadratic trend from 2011–2012 to 2015–2016. 

NOTES: Total dental caries include untreated and treated caries. Access data table for Figure 4 at: https://www.cdc.gov/nchs/data/databriefs/db307_table.pdf#4. 

SOURCE: NCHS, National Health and Nutrition Examination Survey, 2011–2016.

 
NCHS Data Brief ■ No. 307 ■ April 2018

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Summary

For National Health and Nutrition Examination Survey (NHANES) period 2015–2016, the 

prevalence of total and untreated dental caries in primary or permanent teeth among youth aged 

2–19 years was 43.1% and 13.0%, respectively. For both total and untreated caries, prevalence 

was lowest among those aged 2–5 years.

The prevalence of total dental caries was highest for Hispanic youth compared with other race 

and Hispanic-origin groups. The prevalence of untreated dental caries was highest for 

non-Hispanic black youth. 

The prevalence of total and untreated dental caries decreased as family income levels increased. 

Youth in families with incomes greater than 300% of the federal poverty level had the lowest 

prevalence of both untreated and total dental caries. 

The prevalence of total dental caries declined in youth during the 6 years from survey period

2011–2012 through 2015–2016. The prevalence of untreated dental caries increased from

2011–2012 through 2013–2014, and then declined for 2015–2016. 

Definitions

Income: Based on the federal poverty level, which is the ratio of household income to the poverty 

guidelines after accounting for inflation and family size.

Total dental caries: Treated and untreated tooth decay (dental cavity) in primary or permanent teeth.

Untreated dental caries: Tooth decay (dental cavity) in primary or permanent teeth that has not 

received appropriate treatment.
NCHS Data Brief ■ No. 307 ■ April 2018

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Data source and methods

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 (4). It consists of home interviews followed by standardized physical examinations 

in mobile examination centers (MEC). The NHANES sample is selected through a complex, 

multistage probability design. For 2015–2016, non-Hispanic black, non-Hispanic Asian, and 

Hispanic persons were oversampled; for more information, visit the NHANES website, available 

from: https://www.cdc.gov/nchs/nhanes/index.htm. The NHANES caries assessment is a 

comprehensive dental surface-by-dental surface evaluation for the presence of untreated caries and 

dental restorations conducted by trained dentists at the MEC (5).

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 (6). Linear 

regression modeling was used to determine the significance of linear trends. Calculated estimates 

were not age adjusted. Statistical analyses were conducted using SAS-callable SUDAAN version 

11.0 (RTI International, Research Triangle Park, N.C.).

About the authors

Eleanor Fleming is with the National Center for Health Statistics, Division of Health and 

Nutrition Examination Surveys. Joseph Afful is with Peraton Corporation. 
NCHS Data Brief ■ No. 307 ■ April 2018

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References

1. U.S. Department of Health and Human Services. Oral health in America: A report of the 

Surgeon General, Executive summary. Rockville, MD: National Institutes of Health, National 

Institute of Dental and Craniofacial Research. 2000.

2. Seirawan H, Faust S, Mulligan R. The impact of oral health on the academic performance of 

disadvantaged children. Am J Public Health 102(9):1729–34. 2012.

3. Jackson SL, Vann WF Jr, Kotch JB, Pahel BT, Lee JY. Impact of poor oral health on 

children’s school attendance and performance. Am J Public Health 101(10):1900–6. 2011.

4. 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. 

5. National Center for Health Statistics. National Health and Nutrition Examination Survey 

(NHANES): Examination manuals, 2011–2012, 2013–2014, 2015–2016. Available from:

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

6. 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. 307 ■ April 2018

Suggested citation 

Fleming E, Afful J. Prevalence of total and 

untreated dental caries among youth: United 

States, 2015–2016. NCHS Data Brief,

no 307. Hyattsville, MD: National Center 

for Health Statistics. 2018.

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

Jennifer H. Madans, Ph.D., Associate 

Director for Science

Division of Health and Nutrition 

Examination Surveys

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

Ryne Paulose-Ram, Ph.D., Associate 

Director for Science

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