QuickStats: Percentage of Adults Aged 18–64 Years Who Had a Dental Visit in the Past 12 Months, by Dental Insurance and Year — National Health Interview Survey, United States, 2019–2020

April 22, 2022

The percentage of adults aged 18−64 years who had a dental visit during the past 12 months decreased from 65.5% in 2019 to 62.7% in 2020.

From 2019 to 2020, the percentage of adults aged 18−64 years who had a dental visit during the past 12 months decreased for those with dental insurance (75.0% to 72.0%) and those without dental insurance (47.8% to 45.4%).

In both 2019 and 2020, adults with dental insurance were more likely to have a dental visit than those without dental insurance.

Source: National Center for Health Statistics, National Health Interview Survey, 2019 and 2020. https://www.cdc.gov/nchs/nhis.htm

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Q & A with Author: Dental Care Utilization Among Children Aged 1–17 Years: United States, 2019 and 2020

December 2, 2021

Questions for Dzifa Adjaye-Gbewonyo, Health Statistician and Lead Author of “Dental Care Utilization Among Children Aged 1–17 Years: United States, 2019 and 2020.”

Q: Why did you decide to look at children’s dental examinations and cleanings during the pandemic?

DAG: We know that the COVID-19 pandemic required dental providers to make changes to their services, and this affected access to dental care. There have also not been many recent estimates from National Health Interview Survey (NHIS) data on preventive dental care in children, especially covering such a broad age range. So, looking at child dental care and how it changed between 2019 and 2020 was a priority research topic for the Division of Health Interview Statistics, which is responsible for the NHIS.

Q: How did the data vary by age groups, income level and region?

DAG: By age group, children aged 1-4 years had the lowest rate of dental examinations and cleanings in the past 12 months in both 2019 and 2020. They also experienced the largest decrease between the two years, from almost 59% to 51%. This contrasts with older children where the percentage ranged between 88% and 92% across age groups for the two years. By income level, fewer children living in families with lower incomes had a dental examination or cleaning in 2020 compared to 2019, while there was no significant difference between 2019 and 2020 for children with family incomes of at least 400% of the federal poverty level. Regional estimates showed that annual preventive dental visits were highest in the West and Northeast in 2019 and remained high in the West in 2020 but decreased significantly in the Northeast and in the South.

Q: What is the main takeaway message here?

DAG: I think the big takeaway is that overall, fewer children in the U.S. had an annual dental examination or cleaning in 2020 than in 2019, but the change was not the same in all segments of the child population. Some subpopulations were affected more than others, especially young children, children from lower income families, and children living in the Northeast and South. It is also important to note that we can’t fully attribute the changes to the COVID-19 pandemic because the data refer to preventive dental care in the past 12 months. So, some of this time frame took place before the pandemic.

Q: Do you plan to have adult data available for the same years?

DAG: Yes, adult data on dental care were collected and are available for 2019 and 2020. Some estimates of these data are already accessible on the NHIS website, including a data brief on urban-rural differences in dental care in 2019 and interactive quarterly and biannual estimates released through the NHIS Early Release Program. Additional analyses are also planned.

Q: Do you think the downward trend will continue into 2021?

DAG: It’s difficult to say what the trend will be in 2021 since a number of conditions have changed. Though the dental care questions rotated off the NHIS in 2021, they will return in 2022 so it will be possible to look at these data again in future years.

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Urban-rural Differences in Dental Care Use Among Adults Aged 18−64

July 7, 2021

DB412_Cover1Questions for Amy Cha, Health Statistician and Lead Author of “Urban-rural Differences in Dental Care Use Among Adults Aged 18−64.”

Q: How does the data vary by sex, race, and income level?

AC: In both urban and rural areas, the percentage of adults aged 18-64 who had a dental visit in the past 12 months was higher among women and non-Hispanic white adults than men and Hispanic adults. Also, the percentage of adults who had a dental visit increased as family income increased in both urban and rural areas.

Q: Why did you decide to look at dental visits by urbanicity?

AC: Studies have shown that disparities exist in access to and use of dental care, especially between rural and urban areas. So, we decided to look at dental visits by urbanicity.

Q: Were you surprised by any of the findings in this report?

AC: We were surprised that the percentage of adults aged 18-64 with a dental visit in the past 12 months was significantly different between those residing in urban and rural areas.

Q: What is the take home message in this report?

AC: This report examined urban-rural differences in dental care use among adults aged 18-64, and its variation by sex, race and ethnicity, and family income as a percentage of the federal poverty level.

Q: Anything else that you would like share from the report?

AC: It has been reported that persons living in rural areas were less likely to have a preventive dental visit, but more likely to seek emergency dental treatment than those residing in urban areas. As shown in this report, the lower percentage of dental care utilization in rural areas may be attributed to the lower density of dental care providers in these areas.

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QuickStats: Percentage of Adults Who Did Not Get Needed Dental Care Because of Cost in the Past 12 Months, by Age Group and Sex — National Health Interview Survey, United States, 2019

June 25, 2021

In 2019, among adults aged ≥18 years, women (19.2%) were more likely than men (15.6%) not to get needed dental care because of cost in the past 12 months.

The difference by sex was seen for all age groups: 17.7% versus 13.1% among adults aged 18-29 years, 21.5% versus 16.7% among those aged 30–44 years, 21.5% versus 18.7% among those aged 45–64 years, and 14.4% versus 11.9% among those aged ≥65 years.

For both men and women, the percentages were highest among those aged 30–44 and 45–64 years.

For men, the percentages were lowest among those aged 18–29 years and ≥65 years; for women, the percentage was lowest among those aged ≥65 years.

Source: National Center for Health Statistics; National Health Interview Survey, 2019. https://www.cdc.gov/nchs/nhis.htm

https://www.cdc.gov/mmwr/volumes/70/wr/mm7025a5.htm

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QuickStats: Prevalence of Complete Tooth Loss Among Adults Aged 65 Years or Older by Federal Poverty Level — National Health and Nutrition Examination Survey, United States, 1999–2018

September 18, 2020

The age-adjusted prevalence of complete tooth loss among adults aged 65 years or older decreased from 29.3% during 1999–2000 to 12.6% during 2017–2018.

For the same period, the prevalence decreased from 42.1% to 23.5% for adults living at less than 200% of the federal poverty level and from 17.7% to 8.5% for adults living at more than 200% of the federal poverty level.

Throughout the period, the prevalence of complete tooth loss was higher among those living at less than 200% of the federal poverty level.

Sources: Fleming E, Afful J, Griffin SO. Prevalence of tooth loss among older adults: United States, 2015–2018. NCHS data brief, no. 368. https://www.cdc.gov/nchs/products/databriefs/db368.htm. National Center for Health Statistics, National Health and Nutrition Examination Survey, 2015–2018. https://www.cdc.gov/nchs/nhanes.htm.

https://www.cdc.gov/mmwr/volumes/69/wr/mm6937a8.htm

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QuickStats: Percentage of Adults Who Volunteered or Worked in a Hospital, Medical Clinic, Doctor’s Office, Dentist’s Office, Nursing Home, or Some Other Health Care Facility by Sex, Race, and Hispanic Origin — National Health Interview Survey, United States, 2016–2018

July 17, 2020

During 2016–2018, women aged 18 years or older were more likely to volunteer or work in a hospital, medical clinic, doctor’s office, dentist’s office, nursing home, or some other health care facility (health care settings) than were men (12.3% compared with 5.2%).

Non-Hispanic black (15.8%), Asian (12.8%), and white women (12.3%) were more likely to volunteer or work in health care settings than were Hispanic women (9.6%).

Non-Hispanic Asian men (7.6%) were more likely to volunteer or work in health care settings than were black (6.0%), white (5.3%), and Hispanic men (3.8%).

Source: National Health Interview Survey, 2016–2018 data. https://www.cdc.gov/nchs/nhis.htm.

https://www.cdc.gov/mmwr/volumes/69/wr/mm6928a7.htm

 

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Prevalence of Tooth Loss Among Older Adults: United States, 2015–2018

June 17, 2020

Questions for Eleanor Fleming, Health Statistician and Lead Author of “Prevalence of Tooth Loss Among Older Adults: United States, 2015–2018.”

Q: Why did you decide to do a report on tooth loss among older U.S. adults?

EF: Tooth loss among older U.S. adults is an important public health issue. Reducing complete tooth loss is a national health goal monitored by Healthy People. From a health perspective, tooth loss diminishes quality of life, impacts nutrition as food choices are limited, and can impede social interactions. Tooth loss is also preventable.

Q: Can you summarize how the data varied by sex, age, race and Hispanic origin, and education?

EF: While the prevalence of complete tooth loss has been diminishing since the 1960s, in other words, older adults are retaining their teeth; in 2015-2018, disparities continue to persist. Overall, the prevalence of complete tooth loss was 12.9%. We found differences in the prevalence of complete tooth loss by sex, age, race and Hispanic origin, and education.

The prevalence of complete tooth loss among adults aged 65 and over and increased with age: 8.9% (aged 65–69), 10.6% (70–74), and 17.8% (75 and over). There were also differences among women and men by age. Among women, prevalence increased in a similar pattern with age (6.9% for adults aged 65–69, 11.7% for 70–74, and 16.6% for 75 and over). There was a different pattern among men. Among men, complete tooth loss was higher in the oldest age group (19.5% for 75 and over) compared with the two younger groups (11.1% and 9.4%, respectively, for those aged 65–69 and 70–74). There were no observed significant differences in the prevalence between men and women.

By race and Hispanic origin, the prevalence of complete tooth loss is similar to patterns that we see in other oral health and health outcomes. There are differences among race and Hispanic and origin. Non-Hispanic black older adults (25.4%) had the highest prevalence of complete tooth loss compared with other race and Hispanic-origin groups. Among men, prevalence was also higher among non-Hispanic black men (23.4%) compared with non-Hispanic white (12.5%) and Hispanic (11.9%) men. Among women, prevalence of complete tooth loss was higher in non-Hispanic black women (26.8%) compared with Hispanic (17.8%) and non-Hispanic white (9.5%) women.

We also found differences in the prevalence of complete tooth loss among older adults by education level. We defined education in terms of less than a high education and a high school education or greater. Adults with less than a high school education had a higher prevalence of complete tooth loss (31.9%) compared with adults with a high school education of greater (9.5%).

Q: Was there a specific finding in the data that surprised you from this report?

EF: The statistical difference between Hispanic men and women was the most surprising finding in this report. It was not surprising that we observed the prevalence of complete tooth loss to be higher among Hispanic women (17.8%) compared to non-Hispanic women (9.5%). Nor, was it surprising that the prevalence of complete tooth loss among Hispanic men (11.9%) was lower compared to non-Hispanic white men (12.5%). However, a statistical difference Hispanic men and women was not expected.

When you look at the prevalence tooth loss by age among men and women, it is also striking that there were no statistical differences between men and women. While the pattern of estimates with age was difference, none of these differences were statistically different. One would hope to see either a similar pattern or statistical differences. Finding neither is striking.

Q: How did you obtain this data for this report?

EF: This report used National Health and Nutrition Examination Survey data, survey years 1999-2000 to 2017-2018. The survey includes an oral health examination, where dental examiners who are trained and licensed to practice in the United States conduct a tooth count. They assess whether a tooth is present or absence or all 32 teeth. We used these data to assess the absence of teeth in all teeth. Because the protocol for assess tooth count was similar in the survey years, we could combine the data. It should be noted, however, that protocols for the tooth count were similar, the dental examiners were not always dentists; licensed dental hygienists collected data for certain survey cycles.

Q: Is there any trend data that goes back further than 1999?

EF: This report includes trend data starting at 1999 with continuous data, meaning that survey has collected data continuously. While the oral health component has been part of the survey since its inception in 1959, we focused on these more recent, continuous data.

From 1999–2000 through 2017–2018, the age-adjusted prevalence of complete tooth loss decreased from 29.9% to 13.1%. The prevalence has decreased for both men and women.

Q: What is the take home message for this report?

EF: Overall, the prevalence of complete tooth loss among adults aged 65 and over was 12.9%, and the age-adjusted prevalence has decreased since 1999-2000. This is great news, as more older adults are retaining their teeth. However, for 12.9% of older adults to be without their teeth has tremendously public health importance and signals that additional work is needed.

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QuickStats: Age-Adjusted Percentage of Adults Aged 25 Years or Older Who Saw a Dentist in the Past Year by Education Level and Sex

February 21, 2020

In 2018, among adults aged 25 years or older, women (69.4%) were more likely than men (61.2%) to have seen a dentist in the past year.

The percentage of men and women who saw a dentist in the past year increased as education level increased. Among women, those with a Bachelor’s degree or higher were the most likely to have seen a dentist in the past year (82.5%) and those with less than a high school education were least likely (51.4%).

Among men, the same pattern prevailed (74.6% compared with 41.9%).

Within each education group, the percentage of women who saw a dentist in the past year was higher than the percentage of men.

Source: National Health Interview Survey, 2018. https://www.cdc.gov/nchs/nhis/index.htm.

https://www.cdc.gov/mmwr/volumes/69/wr/mm6907a6.htm

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QuickStats: Percentage of Adults Aged 18 Years or Older Who Have Lost All of Their Natural Teeth, by Age Group — National Health Interview Survey, 2000 and 2017

June 7, 2019

The percentage of adults aged 18 years or older who had lost all of their upper and lower natural teeth decreased from 9.3% in 2000 to 7.0% in 2017, and this pattern was consistent in each age group shown.

Complete tooth loss declined from 2.9% to 2.3% among adults aged 18–44 years, from 10.1% to 6.5% among adults aged 45–64 years, from 25.6% to 14.2% among adults aged 65–74 years, and from 34% to 24.9% among adults aged 75 years or older.

SOURCE: Summary Health Statistics for U.S. Adults: National Health Interview Survey, 2000. https://www.cdc.gov/nchs/data/series/sr_10/sr10_215.pdfpdf icon. Tables of Summary Health Statistics, 2017. https://ftp.cdc.gov/pub/Health_Statistics/NCHS/NHIS/SHS/2017_SHS_Table_A-6.pdfpdf icon.

https://www.cdc.gov/mmwr/volumes/68/wr/mm6822a5.htm

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Dental Care Among Adults Aged 65 Years and Over, 2017

May 29, 2019

Questions for Lead Author Ellen Kramarow, Health Statistician, of “Dental Care Among Adults Aged 65 Years and Over, 2017.”

Q: Why focus on dental care among adults aged 65 years or older in the United States?

EK: Dental care is often overlooked as people age, but it is an important component of overall health care. Chronic diseases such as diabetes and osteoporosis, which are common among older persons, can affect oral health; in addition, having poor oral health may contribute to some chronic conditions and impact nutrition. Routine dental care is not covered under fee-for-service Medicare, so older adults may have trouble accessing appropriate dental care.

Q: What are the main findings on dental insurance, dental visits, and unmet dental care due to cost?

EK: In 2017, among adults aged 65 and over, 29.2% had dental insurance; 65.6% had a dental visit in the past 12 months; and 7.7% had an unmet need for dental care due to cost.

No statistically significant differences by sex were observed in any of these dental care indicators. Adults aged 65–74 were more likely to have dental insurance, to have visited the dentist in the past 12 months, and to have unmet need for dental care due to cost compared with adults over age 75.

Poor older adults were less likely to have dental insurance and to have visited the dentist, and more likely to have an unmet need for dental care due to cost compared with not-poor older adults.

Q: Are there any reasons why more U.S. adults aged 65 years or older don’t have dental insurance?

EK: Most older adults have access to health insurance through Medicare, which does not cover routine dental care.  Older adults who do have dental insurance may have obtained it through purchase of a separate dental plan, through retiree health benefits, through a Medicare Advantage plan, or through Medicaid.

Q: Was there a specific finding in your report that surprised you?

EK: Only 30.3% of older adults who were edentate (had no natural teeth) had a dental visit in the past 12 months, compared with 73.6% who had at least some natural teeth.  Even edentate adults need dental care to help maintain good oral health.

Q: What is the take home message for this report?

EK: Many older adults do not receive dental care, and access to dental care varies by age, poverty status, and race and Hispanic origin.

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