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CDC: 'Disparities in caries continue'

March 05, 2015

By Craig Palmer

Photo of Dr. Dye
Dr. Dye

Photo of Dr. Thornton-Evans
Dr. Thornton-Evans
Washington — Tooth decay remains one of the most common chronic childhood diseases in the United States despite significant improvements since the first national assessment of oral health in the 1960s, the Centers for Disease Control and Prevention said.

"Disparities in caries continue to persist for some race and ethnic groups in the United States," the CDC National Center for Health Statistics said in a data brief on tooth decay and dental sealant prevalence in U.S. children and adolescents for 2011-12. "Prevalence of dental sealants — applied to the tooth chewing surfaces to help prevent caries — has also varied among sociodemographic groups."

The national oral health assessment was conducted in mobile examination centers by specially-trained licensed dentists during the CDC/NCHS National Health and Nutrition Examination Survey, which is designed to monitor the health and nutritional status of the civilian noninstitutionalized U.S. population. The National Institute of Dental and Craniofacial Research, one of the National Institutes of Health, has co-funded the NHANES oral component for more than 20 years.

Dr. Bruce Dye, a U.S. Public Health Service dental epidemiology officer and lead author of the data brief, offered information on the data's significance.

"Although tooth decay has been declining since the 1960s when national surveying began, 50 years ago — about 3 in 4 children had cavities in adult teeth by age 11. In 2011-12 — about 1 in 4 children had cavities in adult teeth by age 11," Dr. Dye wrote in a presentation.

"Tooth decay is still a common disease in children and adolescents with significant consequences. Children with serious dental problems can have difficulty eating and sleeping, paying attention to parents and concentrating in school."

Asked at a pre-release media webinar for data on fluorosis and tooth decay in relation to sealants, Dr. Dye said respectively, the data is "not analyzed yet" and "it's too early to say." The data brief cited these key findings:

  • Approximately 23 percent of children aged 2-5 years had dental caries in primary teeth.
  • Untreated tooth decay in primary teeth among children aged 2-8 was twice as high for Hispanic and non-Hispanic black children compared with non-Hispanic white children.
  • Among those aged 6-11, 27 percent of Hispanic children had any dental caries in permanent teeth compared with nearly 18 percent of non-Hispanic white and Asian children.
  • About three in five adolescents aged 12-19 had experienced dental caries in permanent teeth and 15 percent had untreated tooth decay.
  • Dental sealants were more prevalent for non-Hispanic white children (44 percent) compared with non-Hispanic black and Asian children (31 percent each) aged 6-11.

The data from the NHANES oral health component, presented by age and race/ethnicity, is the most recent snapshot of the oral health of American youth, the CDC said. The data was analyzed for more than 3,300 youth participants aged 2-19.

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 was assessed for dental caries, restorations and sealants. Dental exams were conducted using a dental light for illumination, a dental mirror and an explorer.

Preliminary data reliability analyses conducted for 2011-12 indicate that examiner performance was similar to prior survey periods using the same dental caries examination methods (1999-2004), the CDC said.

Dr. Dye trained and calibrated dental examiners for the NHANES and produced analytical reports assessing the oral health of the U.S. population. Lead author of the data brief, he recently joined the National Institute of Dental and Craniofacial Research. Dr. Gina Thornton-Evans, CDC Division of Oral Health; Xianfen Li, CDC National Center for Health Statistics; and Dr. Timothy J. Iafolla, NIDCR, co-authored the data brief.

Next in the national assessment of oral health, said Dr. Dye, is reporting on key indicators of oral health in adults and performing more advanced statistical analyses by combining 2011-12 and 2013-14 data.