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CDC: Tooth decay and tooth loss on decline, but disparities remain

May 13, 2015

By Michelle Manchir

Dr. Feinberg

Dr. Dye
Tooth decay and complete tooth loss have declined in the U.S. since the 1960s, but disparities remain between some age groups and races, the Centers for Disease Control and Prevention said in a May 13 data brief.

"Despite all the advances in our ability to prevent, detect and treat dental disease, too many Americans—for a variety of reasons—are not enjoying the best possible oral health," said ADA President Dr. Maxine Feinberg in response to the report.

The data brief, "Dental Caries and Tooth Loss in Adults in the United States, 2011-12," contains these key findings:

  • Among adults aged 20-64, 91 percent had dental caries and 27 percent had untreated tooth decay.
  • Untreated tooth decay was higher for Hispanic (36 percent) and non-Hispanic black (42 percent) adults compared with non-Hispanic white (22 percent) and non-Hispanic Asian (17 percent) adults aged 20-64.
  • Adults aged 20-39 were twice as likely to have all their teeth (67 percent) compared with those aged 40-64 (34 percent).
  • About one in five adults aged 65 and older had untreated tooth decay.
  • Among adults aged 65 and over, complete tooth loss was lower for older Hispanic (15 percent) and non-Hispanic white (17 percent) adults compared with older non-Hispanic black adults (29 percent).

"It is clear that dental caries continues to affect many of us as we age," said Dr. Bruce Dye, a National Institute of Dental and Craniofacial Research dental epidemiology officer and lead author of the data brief.
The ADA released a statement in response to the data brief and called the numbers "sobering."

The data brief states that tooth retention was lower among non-Hispanic black adults (38 percent) compared with non-Hispanic white (51 percent), non-Hispanic Asian (49 percent) and Hispanic (45 percent) adults. Complete tooth loss (edentulism) was higher among Non-Hispanic Blacks (29 percent) and Non-Hispanic Asians (24 percent) than among non-Hispanic Whites (17 percent) and Hispanics (15 percent).

Dr. Feinberg noted this disparity and said, "The disproportionate rates of disease among some minorities is particularly disturbing and underscores the need for greater outreach to these underserved populations."

But there was some data from the CDC report that noted progress. In a webinar May 13, Dr. Dye released information in addition to the data brief that showed what he called a "remarkable" decrease in edentulism in adults since 1960-1962.

In 1960-1962, about 49 percent of 11 million adults aged 65-74 had complete tooth loss, while in 2011-12, about 13 percent of 21 million adults 65 to 74 were edentulous.

"It means that for many Americans, dentures are no longer inevitable," Dry. Dye said.

Data from the National Health and Nutrition Examination Survey were used to produce the May 13 report. Survey participants were selected through a multistage process that includes oversampling in order to obtain reliable estimates of health and nutritional measures for population subgroups, according to the CDC.
In March, the CDC released a report about tooth decay and dental sealant prevalence in U.S. children and adolescents for 2011-12. That reported stated that tooth decay remains one of the most common chronic childhood diseases in the U.S. and that disparities in caries continue to persist for some race and ethnic groups.
Responding to the continued need to improve the nation's oral health, the ADA in 2013 launched Action for Dental Health, a nationwide, community-based movement to provide care now to people who already suffer from untreated disease, strengthen and expand the public/private safety net and increase dental health education and disease prevention.

Dr. Feinberg emphasized the ADA's belief that prevention is the ultimate answer to eliminating the vast majority of dental disease.

"We know that prevention works.  While it is critical to treat disease that has already occurred, the public health community needs to increase its focus on proven means of preventing it," she said.  "Community water fluoridation, sealant programs for children, teaching people how to take care of their families' teeth and gums, and getting the greatest possible number of children and adults into dental homes are the keys to better oral health for everyone.

"We are doubling down, and we urge the broader health care community, federal, state and local officials, the private sector—everyone with a stake in a healthier, more productive nation—to join us."  

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 both aforementioned data briefs.