Dental Caries (Tooth Decay) in Children Ages 2 to 11 Years

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 primary teeth that have been treated, which indicates access to dental care;
• dt (decayed teeth): this is the number of decayed primary 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 a person’s total lifetime tooth decay.

Dental Caries in the Primary (Baby) Teeth: Children Ages 2 to 5 Years

Overall, dental caries (tooth decay) in the primary teeth of children ages 2 to 5 years has declined since the early 1970s, except for the period from 1988–1994 to 1999–2004 when, as assessed in the National Health and Nutrition Examination Survey (NHANES) oral health examination, this age group had a slight but significant increase in caries. From the 1999–2004 NHANES cycle to the last cycle (2011–2016), dental caries in the primary teeth of this age group again decreased. There also was a significant decrease in the percent of young children ages 2 to 5 years with untreated dental caries. Tables 1 through 3 present caries statistics in the primary teeth for children ages 2 to 5 years and for selected subgroups.

Dental Caries in the Primary Teeth (Prevalence): Children Ages 2 to 5 Years

• 23% of children ages 2 to 5 years have had dental caries in their primary teeth in 2011–2016.
• Black and Mexican American children were more likely to have decay than White children in both NHANES cycles.
• Children living in families with low incomes were twice as likely to have decay in their primary teeth as children from families with high incomes in both NHANES cycles.

Table 1. Percent of Children Ages 2 to 5 Years with Caries in the Primary Teeth

Data Source: Centers for Disease Control and Prevention. Oral Health Surveillance Report: Trends in Dental Caries and Sealants, Tooth Retention, and Edentulism, United States, 1999–2004 to 2011–2016. Atlanta, GA: Centers for Disease Control and Prevention, U.S. Department of Health and Human Services; 2019.

Dental Caries in the Primary Teeth (Unmet Needs): Children Ages 2 to 5 Years

• 10% of children ages 2 to 5 years had untreated dental caries in 2011–2016.
• Black and Mexican American children and those living in families with low incomes were twice as likely to have untreated decay than White children and children living in families with high incomes.

Table 2. Percent of Children Ages 2 to 5 Years with Untreated Caries in the Primary Teeth

Data Source: Centers for Disease Control and Prevention. Oral Health Surveillance Report: Trends in Dental Caries and Sealants, Tooth Retention, and Edentulism, United States, 1999–2004 to 2011–2016. Atlanta, GA: Centers for Disease Control and Prevention, U.S. Department of Health and Human Services; 2019.

Dental Caries in the Primary Teeth (Severity): Children Ages 2 to 5 Years

• On average, children ages 2 to 5 years had three primary teeth that had fillings and two that were decayed in 2011–2016.
• While caries severity did not vary among children from different income groups in 2011–2016, children from families with low incomes experienced a significant decline in tooth decay between the 1999–2004 and 2011–2016 NHANES cycles.

Table 3. Primary Teeth, Severity of Decay Measured by Number of Teeth Affected for Children Ages 2 to 5 Years

Data Source: Centers for Disease Control and Prevention. Oral Health Surveillance Report: Trends in Dental Caries and Sealants, Tooth Retention, and Edentulism, United States, 1999–2004 to 2011–2016. Atlanta, GA: Centers for Disease Control and Prevention, U.S. Department of Health and Human Services; 2019.

Dental Caries in the Primary Teeth: Children Ages 6 to 8 Years

Slightly more than half of children ages 6 to 8 years have had caries, the same as in the previous NHANES survey. Significantly fewer children in this group, however, had untreated caries, a decrease of 14 percentage points. Disparities remain, with children of some racial/ethnic groups and those from low-income families more likely to have caries and untreated caries. Tables 4 through 6 present selected caries estimates in the primary teeth for children ages 6 to 8 years and for selected subgroups.

Dental Caries in the Primary Teeth (Prevalence): Children Ages 6 to 8 Years

• 52% of children ages 6 to 8 years have had dental caries in their primary teeth in 2011–2016.
• Black and Mexican American children and those living in families with low incomes were more likely to have decay than White children and those from families with high incomes in both NHANES cycles.

Table 4. Percent of Children Ages 6 to 8 Years with Caries in the Primary Teeth

Data Source: Centers for Disease Control and Prevention. Oral Health Surveillance Report: Trends in Dental Caries and Sealants, Tooth Retention, and Edentulism, United States, 1999–2004 to 2011–2016. Atlanta, GA: Centers for Disease Control and Prevention, U.S. Department of Health and Human Services; 2019.

Dental Caries in the Primary Teeth (Unmet Needs): Children Ages 6 to 8 Years

• 16% of children ages 6 to 8 years had untreated dental caries in 2011–2016.
• Black and Mexican American children were more likely to have untreated decay than White children in both NHANES cycles.
• Children living in low-income households were twice as likely to have untreated decay as white children and those living in high-income households in both NHANES cycles.

Table 5. Percent of Children Ages 6 to 8 Years with Untreated Decay in the Primary Teeth

Data Source: Centers for Disease Control and Prevention. Oral Health Surveillance Report: Trends in Dental Caries and Sealants, Tooth Retention, and Edentulism, United States, 1999–2004 to 2011–2016. Atlanta, GA: Centers for Disease Control and Prevention, U.S. Department of Health and Human Services; 2019.

Dental Caries in the Primary Teeth (Severity): Children Ages 6 to 8 Years

• Children ages 6 to 8 years had an average of 4 decayed or filled primary teeth in both NHANES cycles.
• Mexican American children had more severe decay in their primary teeth in the 2011–2016 NHANES cycle.
• There was a significant decline in the number of decayed primary teeth and significant increase in the number of filled teeth among children from all racial/ethnic groups between the two NHANES cycles.

Table 6. Primary Teeth, Severity of Decay Measured by Number of Teeth Affected in Children Ages 6 to 8 Years

Data Source: Centers for Disease Control and Prevention. Oral Health Surveillance Report: Trends in Dental Caries and Sealants, Tooth Retention, and Edentulism, United States, 1999–2004 to 2011–2016. Atlanta, GA: Centers for Disease Control and Prevention, U.S. Department of Health and Human Services; 2019.

Dental Caries in the the Permanent (Adult) Teeth: Children Ages 6 to 11 Years

Dental caries in children’s permanent teeth declined between the 1970s and the 2011–2016 NHANES cycle. Yet, there are still significant disparities among some population groups. Tables 7–9 provide recent caries estimates in the permanent teeth of children ages 6 to 11 years, as well as by sex, racial/ethnic group, and income.

Units of Measure

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

Dental Caries in the Permanent Teeth (Prevalence): Children Ages 6 to 11 Years

• There was a significant reduction in tooth decay in older children from 1999–2004 to 2011–2016; in both cycles, presence of decay increased with age.
• 17% of children ages 6 to 11 years have had dental caries in their permanent teeth in 2011–2016.
• Black and Mexican American children were more likely to have decay in their permanent teeth than White children in both NHANES cycles.
• Children from low-income households were twice as likely to have dental caries in their permanent teeth than those from high-income households in both NHANES cycles.

Table 7. Percent of Children Ages 6 to 11 Years with Caries in the Permanent Teeth

Data Source: Centers for Disease Control and Prevention. Oral Health Surveillance Report: Trends in Dental Caries and Sealants, Tooth Retention, and Edentulism, United States, 1999–2004 to 2011–2016. Atlanta, GA: Centers for Disease Control and Prevention, U.S. Department of Health and Human Services; 2019.

Dental Caries in the Permanent Teeth (Unmet Needs): Children Ages 6 to 11 Years

• There was a significant reduction in untreated decay in older children between 1999–2004 and 2011–2016, with only 5% of these children having untreated decay in their permanent teeth in 2011–2016.
• Black and Mexican American children and those living in families with low incomes were more likely to have untreated decay in their permanent teeth than White children and those living in families with high incomes.

Table 8. Percent of Children Ages 6 to 11 Years with Untreated Decay in the Permanent Teeth

Data Source: Centers for Disease Control and Prevention. Oral Health Surveillance Report: Trends in Dental Caries and Sealants, Tooth Retention, and Edentulism, United States, 1999–2004 to 2011–2016. Atlanta, GA: Centers for Disease Control and Prevention, U.S. Department of Health and Human Services; 2019.

Dental Caries in the Permanent Teeth (Severity): Children Ages 6 to 11 Years

• Children ages 6 to 11 years had about 2 decayed or filled permanent teeth.
• There were no significant differences in caries severity between NHANES cycles or by income or racial/ethnic group.

Table 9. Permanent Teeth, Severity of Decay Measured by Number of Teeth Affected in Children 6 to 11 Years

Data Source: Centers for Disease Control and Prevention. Oral Health Surveillance Report: Trends in Dental Caries and Sealants, Tooth Retention, and Edentulism, United States, 1999–2004 to 2011–2016. Atlanta, GA: Centers for Disease Control and Prevention, U.S. Department of Health and Human Services; 2019.