Trends in Dental Implant Use in the U.S., 1999-2016, and Projections to 2026

Abstract

Dental implants have become an increasingly popular treatment choice for replacing missing teeth. Yet, little is known about the prevalence and sociodemographic distribution of dental implant use in the United States. To address this knowledge gap, we analyzed data from 7 National Health and Nutrition Examination Surveys from 1999 to 2016. We estimated dental implant prevalence among adults missing any teeth for each survey period overall as stratified by sociodemographic characteristics. We calculated absolute and relative differences from 1999-2000 to 2015-2016 and fit logistic regression models to estimate changes over time. We also used multivariable logistic regression to estimate independent associations of sociodemographic covariates with the presence of any implant. We projected the proportion of patients treated with dental implants into the year 2026 under varying assumptions of how the temporal trend would continue. There has been a large increase in the prevalence of dental implants, from 0.7% in 1999 to 2000 to 5.7% in 2015 to 2016. The largest absolute increase in prevalence (12.9%) was among individuals 65 to 74 y old, whereas the largest relative increase was ~1,000% among those 55 to 64 y old. There was an average covariate-adjusted increase in dental implant prevalence of 14% per year (95% CI, 11% to 18%). Having private insurance (vs. none or public insurance) or more than a high school education (vs. high school or less) was each associated with a 2-fold increase in prevalence, with an almost 13-fold (95% CI, 8 to21) increase for older adults. Dental implant prevalence projected to 2026 ranged from 5.7% in the most conservative scenario to 23% in the least. This study demonstrates that dental implant prevalence among US adults with missing teeth has substantially increased since 1999. Yet access overall is still very low, and prevalence was consistently higher among more advantaged groups.

Keywords: National Health and Nutrition Examination Survey; cross-sectional studies; dental care; endosseous dental implantation; prevalence; projection.

Figure 1.

Implant distribution among adults with missing teeth and receiving implants per the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2016.

Figure 2.

Observed, predicted, and projected implant prevalence among adults with missing teeth in the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2016 and projected to 2021 and 2026. Estimates are from survey-weighted multivariable logistic regression models. For projection scenario 1) trend stops: implant prevalence is estimated to be the same average probability estimated by the regression line in 2015-2016; 2) trend continues at the same pace: the slope of the regression line included all years 2000-2016; 3) trend slows: the slope of the regression line included all years excluding 2015-2016; and 4) trend steepens: the slope of the regression line included all years excluding 1999-2000 and 2001-2002. Solid lines represent the estimated prevalence (for 2016 and earlier) and projected prevalence (after 2016), and dashed lines represent the 95% prediction intervals for those estimates.