Prevalence of Dental Caries Estimates - Summary Report

The NHANES Select Oral Health Prevalence Estimates dataset provides nationally representative estimates of key oral health indicators for the U.S. population, derived from the National Health and Nutrition Examination Survey (NHANES). NHANES is a continuous, cross-sectional survey that combines interviews and standardized clinical dental examinations, making it one of the most reliable sources for monitoring oral health trends over time.

This dataset focuses on prevalence estimates—rather than raw clinical records—for selected oral health outcomes, including dental caries (tooth decay) and untreated dental caries, stratified by survey cycle and demographic characteristics such as age and sex. The data span multiple NHANES cycles beginning in the late 1990s and extending through more recent survey years, enabling longitudinal assessment of population-level oral health patterns in the United States.

Data description

Dataset	National Center for Health Statistics. NHANES Select Oral Health Prevalence Estimates. Data accessed [Last accessed date]. Available from: https://data.cdc.gov/d/ggsw-596z.
Last Updated	April 21, 2025
Publisher	National Center for Health Statistics
Geography	U.S.

Key Variables Typically Included

• Survey years (e.g., 1999–2000, 2001–2002,…., 2017-2018)

• Demographic subgroups (Sex, Age Groups, Race/Hispanic Origin)

  • Sex- Male/Female

  • Age Groups- 6-11, 12-19, 20-34, 35-49, 50-64, 65+, 70+

  • Race- Black Americans, Hispanics, Mexicans, Asian, Whites

• Oral health measures like:

  • Total dental caries (decay experience) in primary or permanent teeth

  • Untreated dental caries (active decay)

  • Complete Tooth Loss

• Prevalence - percentages, standard error, and confidence intervals for each measure

  
  

These allow analysis of both overall and subgroup prevalence across time and population segments.

Important Definitions:

Prevalence: At any given time, prevalence is the ratio of total number of people with active disease to total population sample size.

Prevalence Percentage- Prevalence of number of diseased people per 100 people (Percentage of a population with a disease at a given point of time)

Prevalence Percentage = (# of people with disease / Total # of people in Sample) X 100

Standard Error- Measures the precision of sample mean as compared to true population mean

Upper 95% Confidence interval and Lower 95% Confidence interval – 95% of values lie within the upper and lower limits of confidence interval, giving a picture of entire population more accurately if the variable is significantly different for a sample with normal distribution observations.

Observations

Figure 1.1

1. High Prevalence of Caries Experience (Total Caries):

   • A large majority of U.S. adults have experienced dental caries in permanent teeth, often exceeding ~90% in NHANES analyses (e.g., adults ages 20–69 in early cycles)

Over a period of time the prevalence of dental caries has not significantly decreased, yet the percentage prevalence of untreated dental caries in permanent and primary teeth have reduced which suggests that more patients are utilizing dental services and are aware of the need to get the teeth restored in timely manner.

Although there is need for in-depth assessment to evaluate success of government policies and millions spent on promoting preventative dental services like sealants and fluorides.

One positive inference can be that prevalence of dental caries have not increased over the period of time yet it a slowly and gradually decreasing. Since dental caries is a multifactorial irreversible microbial disease, often having a poor prognosis in presence of acidic environment (often influenced by higher sodas, fruit juice intake as well as poor dietary/oral hygiene maintenance habits), utilizing preventative measures alone will not be helpful unless health education and healthy habits are promoted among grass-root population.

Figure 2.1

As we can see from the chart 2.1 above, average total prevalence is closer to 80, with females having higher prevalence of total dental caries. Contrastingly, males have a higher prevalence of untreated dental caries as compared to females. Also 2013-2014 witnessed a spike in untreated dental caries prevalence and since then there has been constant decline in untreated dental caries prevalence amongst all people with males and females showing similar trends.

2. Children and Adolescents:

   • For children and adolescents, total dental caries in primary or permanent teeth have been substantial. For example, early cycles like 1999–2000, 2003-2004 showed high percentages of caries experience in 2–11 and 12–19 age groups. 

     
     

   • Changes over decades indicate sometimes declines in untreated decay or shifts in patterns of treated vs. untreated caries, as shown in CDC oral health surveillance analyses (e.g., declines in caries among 6–19 years compared with earlier NHANES cycles). 

 Figure 3.1

As per the chart 3.1, prevalence of untreated dental caries in age group of 6-19 years have been gradually decreasing which is a positive sign that Medicaid/ CHIP programs to prevent dental caries have been working very well. Although an important shift might happen to asses direct correlation of these programs and prevalence of untreated dental caries after 2026 since it is expected that many children might loose their Medicaid/CHIP benefits – which might lower utilization of preventative dental services.

3. Untreated Caries:

   • Untreated active decay tends to be lower than total decay experience but remains a persistent public health problem across age groups. In some NHANES cycles, untreated decay among adolescents and children showed measurable percentages that may vary by age and subgroup.

   • With Males showing higher prevalence of untreated dental caries as compared to females

   • According to 2017-2018 survey, Non-Hispanic Whites had the highest prevalence of presence of dental caries. Comparison can be seen in Figure 4.1

Figure 4.1

Conclusion

The NHANES Select Oral Health Prevalence Estimates (ggsw-596z) is a national dataset summarizing U.S. oral health status through prevalence estimates for dental caries and related outcomes across multiple NHANES survey cycles (except 2005 to 2009). It enables comparisons over time and across demographic groups. The broader surveillance context shows high caries experience across all ages, persistent untreated decay, and shifts in prevalence over decades, reflecting changes in public health interventions, dental care access, and population risk factors.

Further discussions should include statistical analysis between various dependent and independent variables affecting dental caries using LLMs and other logistic models. The current data set used has a limits the possibility of an in-depth analysis or reach a substantial conclusion. Yet this provides a very good overview of existing dental care utilization amongst population and changing trends over a period of 10-20 years. In my opinion, this is one of the very important survey to initiate any research studying a longer period of time. Also, from a business/provider standpoint similar analysis can be used to study dental markets and generating market estimates about prevalence of dental diseases against the number of dentists available per 1000 people and estimate the current need for providers against the need for care.

References

National Center for Health Statistics. NHANES Select Oral Health Prevalence Estimates. Data accessed [Last accessed date]. Available from: https://data.cdc.gov/d/ggsw-596z.