NCHS Data Brief ■ No. 96 ■ May 2012

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics

Key findings

Data from the National 

Health and Nutrition 

Examination Survey, 2005–

2008

•	 More than one in five people

had untreated dental caries

and 75% had existing dental

restorations.

•	 Prevalence of untreated

dental caries varied

significantly by poverty level

for all age groups; however,

there was little difference in

dental restoration prevalence by

poverty level for children and

adolescents aged 5–19 years.

•	 Twenty-seven percent of

children and adolescents aged

5–19 years had at least one

dental sealant.

•	 Nearly 38% of non-Hispanic

black adults had not lost a

permanent tooth compared

with 51% for non-Hispanic

white and 52% for MexicanAmerican persons.

•	 Almost 23% of adults aged

65 and over were edentulous.

Oral health is an important contributor to overall health for individuals and

the population. Dental caries both untreated and treated and tooth loss are

key indicators of oral health and are used to monitor oral health status in

the United States and internationally (1,2). Although prevalence of dental

caries has been declining in the United States, the magnitude of the decline

has varied across different population groups during the past two decades

(3). Tooth loss also has been declining in the United States (3), mostly due

to improvements in treatment modalities, patient attitudes regarding tooth

preservation, and better prevention (4). Plastic-like coatings (dental sealants)

have been applied to the chewing surfaces of children’s teeth to prevent tooth

decay and to some extent tooth loss. This report describes the prevalence

of untreated dental caries, existing dental restorations, dental sealants, and

tooth loss in the United States by age, race and ethnicity, and poverty level in

2005–2008.

Keywords: dental caries • dental sealants • edentulism • National Health and 

Nutrition Examination Survey

Untreated dental caries and dental restoration prevalence 

varied by age.

Selected Oral Health Indicators in the 

United States, 2005–2008

Bruce A. Dye, D.D.S., M.P.H.; Xianfen Li, M.S.; and Eugenio D. Beltrán-Aguilar, D.M.D., M.S., Dr.P.H.

Figure 1. Prevalence of untreated dental caries and existing dental restorations in teeth, by age: 

United States, 2005–2008

SOURCE: CDC/NCHS, National Health and Nutrition Examination Survey, 2005–2008.

Untreated dental caries Dental restoration

0

20

40

60

80

100

Percent

21.5

75.5

20.4

38.7

13.3

52.0

25.1

79.2

21.6

91.5

19.6

88.2

20.2

89.0

75 and

over Total 5–11 12–19 20–44 45–64 65–74

Age in years

Please note: A correction was made to the online HTML and PDF versions on June 6, 2012. Click here for more details.

CORRECTION: The word “permanent” was removed from the title of Figure 1 and the Table. This change was made to clarify 

that the prevalence estimates shown for tooth decay and dental restorations was for all teeth present at the time of assessment, 

not permanent teeth alone.
NCHS Data Brief ■ No. 96 ■ May 2012

■  2  ■

In 2005–2008, more than one in five people had untreated dental caries and three in four people

had at least one dental restoration in the United States (Figure 1). Untreated dental caries among

children aged 5–11 years was 20% and was 13% among adolescents aged 12–19. The prevalence

of untreated caries among younger adults aged 20–44 was 25% and gradually decreased among

the older age groups to approximately 20% for adults aged 65 and over. The prevalence of

existing dental restorations increased as individuals aged from childhood into adulthood and

plateaued in age groups starting at 45 and over. Thirty-nine percent of children aged 5–11 years

and 52% of adolescents aged 12–19 had a dental restoration. The prevalence of having a dental

restoration increased to 79% for adults aged 20–44 and then to nearly 92% for those aged 45–64.

For older adults, dental restoration prevalence was 88% for those aged 65–74 and 89% for those

aged 75 and over.

Untreated dental caries and existing dental restoration prevalence varied 

by race and ethnicity and poverty level across the lifespan. 

Prevalence of untreated caries was nearly twice as high for non-Hispanic black persons (34%)

compared with non-Hispanic white persons (18%) in 2005–2008 (Table). Prevalence of untreated

caries was significantly higher for both non-Hispanic black and Mexican-American persons

compared with non-Hispanic white children, adults, and older adults. Among persons aged 5–19

years, untreated caries were at least twice as high for those living below 100% of the poverty

level (25%) compared with those living at 200% of the federal poverty level or higher (12%).

Prevalence of untreated caries was significantly higher for adults living below 100% of the

federal poverty level compared with those living at the 200% level or higher.

Table. Prevalence of untreated dental caries and existing dental restorations in teeth, by sex, race and ethnicity, and 

poverty level: United States, 2005–2008

Characteristic

Untreated dental caries Dental restoration

Age in years

Total 5–19 20–64 65 and 

over

Total 5–19 20–64 65 and 

over

Total 21.5 16.6 23.7 19.9 75.5 45.9 84.3 88.5

Race and ethnicity

Non-Hispanic white1 17.8 13.3 19.3 17.8 80.1 46.2 88.8 91.6

Non-Hispanic black 234.2 222.6 239.7 235.8 262.6 240.4 273.1 263.7

Mexican American 231.1 222.4 235.2 236.4 261.8 50.1 267.4 269.3

Poverty level

Below 100% 235.8 225.4 241.9 241.3 262.7 48.6 271.5 263.3

100% to less than 200% 230.5 219.3 237.7 222.5 268.8 46.3 275.1 285.6

200% or higher1 15.5 12.1 16.6 15.3 80.2 44.5 89.0 92.6

Sex 

Male 224.6 17.6 227.2 225.1 272.1 44.8 280.5 286.3

Female1 18.6 15.5 20.2 15.6 78.7 47.0 88.0 90.4

1

Reference group.

2

p < 0.05.

SOURCE: CDC/NCHS, National Health and Nutrition Examination Survey, 2005–2008.

CORRECTION: The word “permanent” was removed from the title of Figure 1 and the Table. This change was made to clarify that the prevalence estimates 

shown for tooth decay and dental restorations was for all teeth present at the time of assessment, not permanent teeth alone.
NCHS Data Brief ■ No. 96 ■ May 2012

■  3  ■

Dental restoration prevalence was significantly lower for both non-Hispanic black and MexicanAmerican persons (62%) compared with non-Hispanic white persons (80%) in 2005–2008.

Although both non-Hispanic black and Mexican-American adults had a significantly lower

prevalence of dental restorations compared with non-Hispanic white adults, only non-Hispanic

black children and adolescents (40%) had a significantly lower prevalence compared with nonHispanic white children and adolescents (46%). Among persons aged 5–19 years, the prevalence

of dental restorations ranged from nearly 45% for those living at 200% or higher of the federal

poverty level to nearly 49% for persons living below 100% of the poverty level. Prevalence

of dental restorations was significantly lower for adults aged 20–64 living below 100% of the

poverty level (72%) compared with adults living at 200% of the poverty level or higher (89%).

For adults aged 65 and over living in poverty, dental restoration prevalence was significantly

lower (63%) compared with those living at 200% of the poverty level or higher (93%).

Among children and adolescents aged 5–19 years, dental sealant 

prevalence was highest among non-Hispanic white persons and those 

living at 200% or more of the poverty level. 

Twenty-seven percent of children and adolescents aged 5–19 years had at least one dental sealant

on a permanent tooth. Thirty percent of non-Hispanic white children and adolescents had a dental

sealant compared with 23% for Mexican-American and 17% for non-Hispanic black children

and adolescents (Figure 2). Dental sealant prevalence was significantly lower for children and

adolescents aged 5–19 years living below 200% of the poverty level (20%–22%) compared with

those living at 200% of the poverty level or higher (32%).

1

Reference group.

2

p < 0.05.

SOURCE: CDC/NCHS, National Health and Nutrition Examination Survey, 2005–2008.

Figure 2. Prevalence of dental sealants on permanent teeth, by race and ethnicity and poverty level among persons aged 

5–19 years: United States, 2005–2008

27.2

30.2

2

17.3

2

22.6

2

19.7

2

21.9

32.3 200% of poverty

level or higher1

100% to less than 200%

of poverty level

Below 100% of

poverty level

Mexican American

Non-Hispanic black

Non-Hispanic white1

Total

0 5 10 15

Percent

20 25 30 35
NCHS Data Brief ■ No. 96 ■ May 2012

■  4  ■

More non-Hispanic white and Mexican-American adults had retained all of 

their permanent teeth compared with non-Hispanic black adults. 

Approximately 49% of adults aged 20–64 had a full set of permanent teeth (excluding third

molars) (Figure 3). Tooth retention was higher among Mexican-American (52%) and nonHispanic white (51%) persons, whereas only 38% of non-Hispanic black persons had experienced

no tooth loss due to dental disease. For adults aged 20–64 living at 200% of poverty level or

higher, 52% had not lost a permanent tooth; approximately 40% of adults living below 100% of

the poverty level had retained all of their permanent teeth.

Edentulism was significantly higher among older adults living in poverty 

compared with those living at 200% of the poverty level or higher. 

Twenty-three percent of adults aged 65 and over were edentulous (Figure 4). More non-Hispanic

black adults aged 65 and over were edentulous (32%) compared with non-Hispanic white adults

(22%), whereas only 16% of Mexican-American adults had complete tooth loss. The prevalence

of complete tooth loss was more than twice as high for older adults living below 100% of the

poverty level (37%) compared with those living at 200% of the poverty level or higher (16%).

1

Reference group.

2

p < 0.05.

SOURCE: CDC/NCHS, National Health and Nutrition Examination Survey, 2005–2008.

Figure 3. Prevalence of complete tooth retention, by race and ethnicity and poverty level among adults aged 20–64: 

United States, 2005–2008

200% of poverty

 level or higher1

100% to less than 200%

of poverty level

Below 100% of

poverty level

Mexican American

Non-Hispanic black

Non-Hispanic white1

Total

Percent

0 10 20 30 40 50 60

48.6

51.0

2

37.6

52.3

2

40.4

2

44.1

51.8
NCHS Data Brief ■ No. 96 ■ May 2012

■  5  ■

Summary

In the United States, oral health status varied by age, race and ethnicity, and poverty level.

Approximately 17% of children and adolescents aged 5–19 years had untreated dental caries and

46% had a dental restoration. Twenty percent of children aged 5–11 years and 13% of adolescents

aged 12–19 had untreated caries. Untreated dental caries was significantly higher in MexicanAmerican and non-Hispanic black children and adolescents (23%) compared with non-Hispanic

white children and adolescents (13%). One-half of Mexican-American children and adolescents

had a dental restoration. Dental restoration prevalence was significantly lower for non-Hispanic

black persons (40%) compared with non-Hispanic white persons (46%). Although dental sealant

prevalence was 27% for all children and adolescents, more non-Hispanic white persons (30%)

had a dental sealant compared with Mexican-American (23%) and non-Hispanic black (17%)

persons.

Twenty-five percent of children and adolescents living in poverty had untreated dental caries

compared with 12% for those living at 200% of the poverty level or higher. There was little

difference in dental restoration prevalence by poverty level among persons aged 5–19 years,

with prevalence ranging from nearly 45% for those living at 200% or higher of the federal

poverty level, to nearly 49% for persons living below 100% of the poverty level. Dental sealant

prevalence was significantly lower for those living below 100% of the poverty level (20%)

compared with those living at 200% or more of the poverty level (32%).

Nearly 24% of adults aged 20–64 had untreated dental caries and 84% had a dental restoration.

Prevalence of untreated dental caries was significantly higher in non-Hispanic black (40%)

and Mexican-American (35%) adults compared with non-Hispanic white adults (19%). Dental

restoration prevalence was significantly lower for Mexican-American (68%) and non-Hispanic

black (73%) adults compared with non-Hispanic white adults (89%). Although Mexican1

Reference group.

2

p < 0.05.

SOURCE: CDC/NCHS, National Health and Nutrition Examination Survey, 2005–2008.

Figure 4. Prevalence of complete tooth loss (edentulism), by race and ethnicity and poverty level among adults aged 65 

and over: United States, 2005–2008

200% of poverty

level or higher1

100% to less than 200%

of poverty level

Below 100% of

poverty level

Mexican American

Non-Hispanic black

Non-Hispanic white1

Total

Percent

22.9

21.9

2

32.0

15.7

2

36.8

2

31.4

16.1

0 5 10 15 20 25 30 35 40
NCHS Data Brief ■ No. 96 ■ May 2012

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American persons had untreated caries and dental restorations at levels indicating a significant

disparity when compared with non-Hispanic white persons, complete tooth retention was

comparable between Mexican-American (52%) and non-Hispanic white (51%) adults.

Untreated caries was significantly higher among adults aged 20–64 living in poverty (42%)

compared with those living at 200% of the poverty level or higher (17%). Dental restoration

prevalence was significantly lower for adults living in poverty (72%) compared with those living

at 200% of the poverty level or higher (89%). More adults living at 200% of the poverty level or

higher had not lost a tooth due to dental disease (52%) compared with those living below 100%

of the poverty level (40%).

Twenty percent of adults aged 65 and over had untreated dental caries and 89% had a dental

restoration. The prevalence of untreated caries and dental restorations was similar for older adults

aged 65–74 and 75 and over. Twice as many non-Hispanic black and Mexican-American older

adults (36%) had untreated caries compared with non-Hispanic white older adults (18%). Ninetytwo percent of non-Hispanic white older adults had at least one dental restoration, whereas less

than 70% of Mexican-American and non-Hispanic black older adults had a dental restoration.

Edentulism was significantly higher among non-Hispanic black older adults (32%) compared

with non-Hispanic white older adults (22%), but only 16% of Mexican-American older adults

were edentulous.

Prevalence of untreated caries was nearly three times greater among adults aged 65 and over

living in poverty (41%) compared with those living at 200% of the poverty level or higher (15%).

Dental restoration prevalence was significantly lower for adults living in poverty (63%) compared

with those living at 200% of the poverty level or higher (93%). Edentulism was more than twice

as high among older adults living below 100% of the poverty level (16%) compared with those

living at 200% of the poverty level or higher (37%).

Definitions

Untreated dental caries: Describes dental cavities that have not received appropriate treatment.

Dental restoration: Refers to having a dental filling, crown, or other type of restorative dental

material applied to the tooth regardless of the dental material type, such as amalgam, composite

resin, gold alloy, and ceramic.

Dental sealants: Describes plastic-like coatings applied to the chewing surfaces of back teeth. The

applied sealant resin bonds into the grooves of teeth to form a protective physical barrier.

Tooth retention: Refers to having all natural permanent teeth present, excluding third molars.

Edentulism: Refers to having all natural permanent teeth missing, including third molars.

Poverty status or percentage of poverty level: Poverty status is based on family income, family

size, and the number of children in the family, and for families with two or fewer adults, on the

age of the adults in the family. The poverty level is based on definitions originally developed by

the Social Security Administration and includes a set of income thresholds that vary by family

size and composition. Families or individuals with income below their appropriate thresholds are

classified as below the poverty level. These thresholds are updated annually by the U.S. Census

Bureau. Additional information can be found at http://aspe.hhs.gov/poverty/11poverty.shtml.
NCHS Data Brief ■ No. 96 ■ May 2012

■  7  ■

Data source and methods

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

for these analyses. NHANES is a cross-sectional survey designed to monitor the health and

nutritional status of the civilian noninstitutionalized U.S. population. The NHANES sample

is selected through a complex, multistage design that includes selection of primary sampling

units (PSUs) (counties or county equivalents), household segments within PSUs, and sample

persons from selected households. The sample design includes oversampling in order to

obtain reliable estimates of health and nutritional measures for population subgroups. In

2005–2008, oversampling included non-Hispanic black and Mexican-American persons.

Additional information on NHANES can be found at http://www.cdc.gov/nchs/nhanes/nhanes_

questionnaires.htm.

From 2005 through 2008, the NHANES oral health assessment was conducted in mobile

examination centers by trained health technologists rather than dental professionals. The oral

health screening included a person-based assessment for dental caries, restorations, and sealants,

and was conducted using a dental light for illumination, and a disposable mirror. The screening

was a fast and simple process by which an examiner visually inspected the oral cavity to detect

the presence or absence of specific oral conditions. Overall examiner reliability findings indicated

that health technologist performance was excellent. Additional information regarding the 2005–

2008 oral health screening and quality assurance issues are published elsewhere (5).

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

(release 10.0; RTI International, Research Triangle Park, N.C.). 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. The statistical significance of differences between

estimates were evaluated using two-sided t tests at the α = 0.05 level compared with a reference

group within the selected variable. Calculated estimates were not age adjusted and no adjustments

were made for multiple comparisons.

About the authors

Bruce A. Dye and Xianfen Li are with the Centers for Disease Control and Prevention’s (CDC)

National Center for Health Statistics, Division of Health and Nutrition Examination Surveys.

Eugenio D. Beltrán-Aguilar is with CDC’s National Center for Chronic Disease Prevention and

Health Promotion, Division of Oral Health.
NCHS Data Brief ■ No. 96 ■ May 2012

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References

1.	 U.S. Department of Health and Human Services. Healthy People 2010.

2nd ed. With: Understanding and improving health, and Objectives for

improving health. 2 vols. Washington, DC: U.S. Government Printing Office.

2000.

2.	 Petersen PE. The world oral health report 2003: Continuous

improvement of oral health in the 21st century—The approach of the

WHO Global Oral Health Programme. Geneva, Switzerland: World Health

Organization. 2003.

3.	 Dye BA, Tan S, Smith V, et al. Trends in oral health status: United States,

1988–1994 and 1999–2004. Vital Health Stat 11(248). 2007.

4.	 Burt BA, Eklund SA. Dentistry, Dental Practice, and the Community, 6th

ed. St. Louis, MO: W.B. Saunders Company. 2005.

5.	 Dye BA, Barker LK, Li X, Lewis BG, Beltrán-Aguilar ED. Overview

and quality assurance for the oral health component of the National Health

and Nutrition Examination Survey (NHANES), 2005–08. J Public Health

Dent 71(1):54–61. 2011.

Suggested citation

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.

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

Edward J. Sondik, Ph.D., Director

Jennifer H. Madans, Ph.D., Associate 

Director for Science

Division of Health and Nutrition 

Examination Surveys

Clifford L. Johnson, M.S.P.H., Director