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? (The reporter could also say “Any other comments?”)

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.


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.


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


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.


QuickStats: Age-Adjusted Percentage of Adults Aged 18 Years or Older Who Reported That They Needed Dental Care During the Past 12 Months But Didn’t Get It Because They Couldn’t Afford It, by Sex, Race, and Hispanic Origin

March 22, 2019

In 2017, more women (12.7%) than men (8.8%) reported that at some time during the past 12 months they needed dental care but didn’t get it because they couldn’t afford it.

This pattern was consistent within each racial/ethnic group: Hispanic, non-Hispanic white, and non-Hispanic black.

Among both men and women, Hispanic adults were most likely to have unmet needs for dental care because they couldn’t afford it.

Nearly 17% of Hispanic women could not afford to meet their dental care needs, compared with 12.8% of non-Hispanic black women and 11.8% of non-Hispanic white women; 12.3% of Hispanic men had unmet dental care needs, compared with 8.6% of non-Hispanic black men and 8.3% of non-Hispanic white men.

Source: Tables of Summary Health Statistics, 2017.

https://ftp.cdc.gov/pub/Health_Statistics/NCHS/NHIS/SHS/2017_SHS_Table_A-19.pdf.

https://www.cdc.gov/mmwr/volumes/68/wr/mm6811a4.htm