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Dental Caries (Tooth Decay) in Children (Age 2 to 11)

Dental Caries in Primary (Baby) Teeth

Overall dental caries in the baby teeth of children 2 to 11 declined from the early 1970s until the mid 1990s. From the mid 1990s until the most recent (1999-2004) National Health and Nutrition Examination Survey, this trend has reversed: a small but significant increase in primary decay was found. This trend reversal was more severe in younger children. Tables 1 through 4 present selected caries estimates in primary teeth for children aged 2–11 years and for selected subgroups.

Prevalence (Table 1)

42% of children 2 to 11 have had dental caries in their primary teeth.
Black and Hispanic children and those living in families with lower incomes have more decay.

Unmet Needs (Table 2)

23% of children 2 to 11 have untreated dental caries.
Black and Hispanic children and those living in families with lower incomes have more untreated decay.

Severity (Table 3 and Table 4)

Children 2 to 11 have an average of 1.6 decayed primary teeth and 3.6 decayed primary surfaces.
Black and Hispanic subgroups and those with lower incomes have more severe decay in primary teeth.
Black and Hispanic subgroups and those with lower incomes have more untreated primary teeth.

Dental Caries in Permanent (Adult) Teeth

Dental caries in children’s permanent teeth declined from the early 1970s until the mid 1990s. Significant disparities are found in some population groups. Tables 5 through 8 present selected caries estimates in permanent teeth for children aged 2–11 years and for selected subgroups.

Prevalence (Table 5)

21% of children 6 to 11 have had dental caries in their permanent teeth.
Hispanic children and those living in families with lower incomes have more decay in their permanent teeth.

Unmet Needs (Table 6)

8% of children 6 to 11 have untreated decay.
Hispanic children and those living in families with lower incomes have more untreated decay.

Severity (Table 7 and Table 8)

Children 6 to 11 have about 0.45 decayed permanent teeth and 0.68 decayed permanent surfaces.
Black and Hispanic subgroups and those with lower incomes have more severe decay in both permanent teeth and surfaces.
Black and Hispanic subgroups and those with lower incomes have more untreated permanent teeth and surfaces.

Units of Measure: Dental caries is measured by a dentist examining a child’s teeth, and recording the ones with untreated decay and the ones with fillings. This provides three important numbers:

ft (filled teeth): this is the number of decayed teeth that have been treated, which indicates access to dental care;
dt (decayed teeth): this is the number decayed teeth that have not been treated, which measures unmet need; and
dft (decayed and filled teeth): this is the sum of ft and dt, and is the measure of person’s total lifetime tooth decay.

In addition to counting decayed and filled teeth, this same information can be gathered at the tooth surface level. Since every tooth has multiple surfaces, counting the decayed or filled surfaces provides a more accurate measure of the severity of decay. The following tables list both methods of measuring caries.

Table 1: Children, Percent with Caries in Primary Teeth

Prevalence of caries in primary teeth (dft) among youths 2–11 years of age, by selected characteristics:
United States, National Health and Nutrition Examination Survey, 1999–2004

Characteristic	Percent with caries in primary teeth
*Age*
2 to 5 years	27.90
6 to 11 years	51.17

*Sex*
Male	44.43
Female	39.80

*Race and Ethnicity*
White, non-Hispanic	38.56
Black, non-Hispanic	43.34
Mexican American	55.40

*Poverty Status* (Income compared toFederal Poverty Level)
Less than 100%	54.33
100% to 199%	48.75
Greater than 200%	32.30

*Overall*	42.17

Data Source: The National Health and Nutrition Examination Survey (NHANES) has been an important source of information on oral health and dental care in the United States since the early 1970s. Tables 1 through 4 present the latest NHANES (collected between 1999 and 2004) data regarding dental caries in children.

Table 2: Percent of Children with Untreated Decay in Primary Teeth,

Prevalence of untreated decay in primary teeth (dt) among youths 2–11 years of age, by selected characteristics:
United States, National Health and Nutrition Examination Survey, 1999–2004

Characteristic	Percent with untreated decay in primary teeth (dt)
*Age*
2 to 5 years	20.48
6 to 11 years	24.49

*Sex*
Male	24.16
Female	21.66

*Race and Ethnicity*
White, non-Hispanic	19.47
Black, non-Hispanic	27.58
Mexican American	33.09

*Poverty Status* (Income compared toFederal Poverty Level)
Less than 100%	32.52
100% to 199%	28.40
Greater than 200%	15.01

*Overall*	22.94

Table 3: Primary Teeth, Severity of Decay Measured by Tooth

Mean number of decayed, filled, and decayed or filled primary teeth among youths 2–11 years of age, by selected characteristics: United States, National Health and Nutrition Examination Survey, 1999–2004

Characteristic	Decayed primary teeth (dt)	Filled primary teeth (ft)	Total decayed or filled primary teeth (dft)
*Age*
2 to 5 years	.71	.47	1.17
6 to 11 years	.58	1.26	1.84

*Sex*
Male	.66	1.01	1.67
Female	.59	.89	1.48

*Race and Ethnicity*
White, non-Hispanic	.53	.93	1.46
Black, non-Hispanic	.72	.73	1.45
Mexican American	.90	1.28	2.18

*Poverty Status* (Income compared toFederal Poverty Level)
Less than 100%	1.01	1.33	2.34
100% to 199%	.80	1.09	1.89
Greater than 200%	.34	.70	1.07

*Overall*	0.63	0.95	1.58

Table 4: Primary Teeth, Severity of Decay Measured by Tooth Surface

Mean number of decayed, filled, and decayed or filled primary tooth surfaces among youths 2–11 years of age, by selected characteristics: United States, National Health and Nutrition Examination Survey, 1999–2004

Characteristic	Decayed primary surfaces (ds)	Filled primary surfaces (fs)	Total decayed or filled primary surfaces (dfs)
*Age*
2 to 5 years	1.25	1.33	2.58
6 to 11 years	0.98	3.32	4.30

*Sex*
Male	1.17	2.78	3.95
Female	0.99	2.29	3.28

*Race and Ethnicity*
White, non-Hispanic	0.92	2.55	3.46
Black, non-Hispanic	1.22	1.80	3.02
Mexican American	1.47	3.25	4.72

*Poverty Status* (Income compared toFederal Poverty Level)
Less than 100%	1.84	3.79	5.63
100% to 199%	1.39	3.05	4.45
Greater than 200%	0.53	1.75	2.28

*Overall*	1.08	2.55	3.63

Tables 5 through 8 present selected caries estimates in permanent teeth for children aged 6–11 years and for selected subgroups.

FT (filled teeth): this is the number of decayed teeth that have been treated, which indicates access to dental care;
DT (decayed teeth): this is the number decayed teeth that have not been treated, which measures unmet need; and
DFT (decayed and filled teeth): this is the sum of DT and FT, and is the measure of person’s total lifetime tooth decay.

In addition to counting decayed and filled teeth, this same information can be gathered at the tooth surface level. Since every tooth has multiple surfaces, counting the decayed or filled surfaces provides a more accurate measure of the severity of tooth decay. The following tables list both methods of measuring tooth decay.

Table 5: Children, Percent with Decay in Permanent Teeth

Prevalence of tooth decay in permanent teeth (DFT) among youths 6–11 years of age, by selected characteristics:
United States, National Health and Nutrition Examination Survey, 1999–2004

Characteristic	Percent with decay in permanent teeth
*Age*
6 to 8 years	10.16
9 to 11 years	31.36

*Sex*
Male	19.36
Female	22.87

*Race and Ethnicity*
White, non-Hispanic	18.59
Black, non-Hispanic	19.03
Mexican American	30.76

*Poverty Status* (Income compared toFederal Poverty Level)
Less than 100%	28.28
100% to 199%	24.09
Greater than 200%	16.31

*Overall*	21.06

Table 6: Percent of Children with Untreated Decay in Permanent Teeth,

Prevalence of untreated tooth decay in permanent teeth (DT) among youths 6–11 years of age, by selected characteristics:
United States, National Health and Nutrition Examination Survey, 1999–2004

Characteristic	Percent with untreated decay in permanent teeth (DT)
*Age*
6 to 8 years	4.05
9 to 11 years	11.05

*Sex*
Male	7.45
Female	7.91

*Race and Ethnicity*
White, non-Hispanic	5.56
Black, non-Hispanic	8.55
Mexican American	12.71

*Poverty Status* (Income compared toFederal Poverty Level)
Less than 100%	11.76
100% to 199%	11.94
Greater than 200%	3.57

*Overall*	7.65

Table 7: Permanent Teeth, Severity of Tooth Decay Measured by Tooth

Mean number of decayed, filled, and decayed or filled permanent teeth among youths 6–11 years of age, by selected characteristics: United States, National Health and Nutrition Examination Survey, 1999–2004

Characteristic	Decayed permanent teeth (DT)	Filled permanent teeth (FT)	Total decayed or filled permanent teeth (DFT)
*Age*
6 to 8 years	0.06	0.13	0.19
9 to 11 years	0.19	0.50	0.69

*Sex*
Male	0.11	0.29	0.41
Female	0.14	0.34	0.49

*Race and Ethnicity*
White, non-Hispanic	0.08	0.29	0.38
Black, non-Hispanic	0.14	0.27	0.43
Mexican American	0.22	0.47	0.70

*Poverty Status* (Income compared toFederal Poverty Level)
Less than 100%	0.18	0.44	0.63
100% to 199%	0.21	0.33	0.55
Greater than 200%	0.05	0.26	0.32

*Overall*	0.12	0.32	0.45

Table 8: Permanent Teeth, Severity of Tooth Decay Measured by Tooth Surface

Mean number of decayed, filled, and decayed or filled permanent tooth surfaces among youths 6–11 years of age, by selected characteristics: United States, National Health and Nutrition Examination Survey, 1999–2004

Characteristic	Decayed permanent surfaces (DS)	Filled permanent surfaces (FS)	Total decayed or filled permanent surfaces (DFS)
*Age*
6 to 8 years	0.07	0.19	0.29
9 to 11 years	0.26	0.76	1.06

*Sex*
Male	0.15	0.45	0.61
Female	0.20	0.52	0.76

*Race and Ethnicity*
White, non-Hispanic	0.10	0.42	0.55
Black, non-Hispanic	0.21	0.43	0.70
Mexican American	0.30	0.81	1.12

*Poverty Status* (Income compared toFederal Poverty Level)
Less than 100%	0.28	0.69	1.02
100% to 199%	0.29	0.51	0.82
Greater than 200%	0.06	0.38	0.47

*Overall*	0.17	0.48	0.68

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