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. 2019 Jan;150(1):9-23.e3.
doi: 10.1016/j.adaj.2018.09.010. Epub 2018 Nov 29.

Tooth loss among older adults according to poverty status in the United States from 1999 through 2004 and 2009 through 2014

Bruce A Dye, Darien J Weatherspoon, Gabriela Lopez Mitnik

Tooth loss among older adults according to poverty status in the United States from 1999 through 2004 and 2009 through 2014

Bruce A Dye et al. J Am Dent Assoc. 2019 Jan.

Abstract

Background: As tooth loss decreases in an aging United States, retaining enough natural teeth for function is important for quality of life.

Methods: The authors used data from the 1999 through 2004 and the 2009 through 2014 National Health and Nutrition Examination Surveys to assess changes in tooth loss in adults 50 years or older. The authors evaluated changes in edentulism, retaining all teeth, and having a functional dentition (21 or more natural teeth) according to poverty status.

Results: Edentulism was lower in 2009 through 2014 than in 1999 through 2004 (11% versus 17%) for adults 50 years or older, but this decrease was not significant among the poor (people at < 100% of the federal poverty guideline; P > .05). Complete tooth retention improved from 14% to 21% between 1999 through 2004 and 2009 through 2014 for people 50 years or older (P < .05). Gains were attributable mostly to adults who were nonpoor (≥ 200% federal poverty guideline). More older adults had a functional dentition in 2009 through 2014 than in 1999 through 2004 (67% versus 55%; P < .05), although the increases generally were significant only for those not living in poverty.

Conclusions: Complete tooth loss has decreased by more than 75% for those aged 65 through 74 years over the past 5 decades in the United States. Improvements in tooth loss measures, such as edentulism and complete tooth retention, have been most significant among the nonpoor, whereas those who are poor have experienced fewer improvements.

Practice implications: An aging population is experiencing less edentulism and greater tooth retention, so older adults may need more regular oral health care and prevention services to address concerns such as root caries and periodontal disease.

Keywords: Edentulism; National Health and Nutrition Examination Survey; adults; dental public health; epidemiology; functional dentition; health disparities; oral health; poverty.

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Figures

Figure 1.
Figure 1.
Complete tooth loss among adults 65 years of age and older by states, United States 2014
Figure 2.
Figure 2.
Prevalence of each tooth missing for adults 50 years of age and older with contribution to missing by poverty status: United States, 1999-2004 and 2009-2014
Figure 3.
Figure 3.
Heat map of missing teeth for adults 65 years of age and older with contribution to missing by poverty status: United States, 1999-2004 and 2009-2014
Figure 4.
Figure 4.
Estimated total population and prevalence of edentulism among adults 65-74 years of age United States, 1960 to 2014
eFigure 1.
eFigure 1.
Prevalence of each tooth missing for adults 50-64 years of age with contribution to missing by poverty status: United States, 1999-2004 and 2009-2014
eFigure 2.
eFigure 2.
Prevalence of each tooth missing for adults 65-74 years of age with contribution to missing by poverty status: United States, 1999-2004 and 2009-2014
eFigure 3.
eFigure 3.
Prevalence of each tooth missing for adults 75 years of age and older with contribution to missing by poverty status: United States, 1999-2004 and 2009-2014
See this image and copyright information in PMC

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