Epidemiology of Dental Caries Across Age Groups

The global burden of dental caries has undergone marked transformations over recent decades, reflecting shifts in diet, fluoride exposure, healthcare access and population ageing. In childhood and adolescence, caries prevalence has declined in many high-income regions owing to preventive measures, yet remains elevated in underserved communities where sugar consumption and inadequate oral hygiene persist. In adulthood, caries experience is commonly quantified by the DMFT index (decayed, missing, filled teeth), which captures cumulative lifetime burden. Middle-aged adults often present with mixed patterns of decayed and restored surfaces, influenced by socioeconomic status and service utilisation. In older adults, enhanced tooth retention has paradoxically increased restorative need, as teeth are retained into later life but may be at risk of recurrent decay at restoration margins and root-surface caries. Disparities in caries experience mirror inequalities in education, income and access to dental care, with vulnerable groups exhibiting higher untreated disease. Epidemiological surveillance utilises cross-sectional and longitudinal designs to map age-specific trends, identify at-risk populations and inform targeted interventions. Recent modelling anticipates further declines in cumulative caries experience in many countries, but rising restorative needs among seniors underscore the need for tailored preventive strategies across the life course. Global initiatives advocate for integration of oral health into primary care, expansion of preventive fluoride programmes and reduction of sugar intake, with particular emphasis on age-stratified approaches to curb caries inequities and support functional dentition into older age.

Research from Nature Portfolio

Analyses of national oral health surveys have revealed a sustained decrease in cumulative caries experience across children, adults and seniors over the past two decades. In one foundational study, 12-year-olds in a major European country saw mean DMFT fall from approximately 1.7 to 0.5 between the late 1990s and mid-2010s, with projections indicating values near 0.2 by 2030. Adults aged 35–44 exhibited a decline in DMFT from around 16.1 to 11.2 over the same period, while 65–74-year-olds decreased from 23.6 to 17.7. Although the number of missing teeth declined steadily, older adults showed rising numbers of filled and untreated decayed teeth, reflecting greater tooth retention alongside persistent restorative need. Population-level modelling forecasts a reduction in global caries burden but highlights emerging morbidity shifts in ageing societies, calling for new concepts to address restorative demand and maintain oral function in later life.

Epidemiology of Dental Caries Across Age Groups publication trend

The graph below shows the total number of articles in epidemiology of dental caries across age groups across all publications each year (not limited to Nature Index journals).

Technical terms

DMFT index: A summary measure of caries experience counting decayed, missing and filled permanent teeth.

Edentulism: Complete absence of natural teeth in one or both jaws.

Dentate: Presence of one or more natural teeth in the mouth.

Cross-sectional study: An observational design assessing a population at a single point in time.

References

1. Trends in caries experience in the permanent dentition in Germany 1997–2014, and projection to 2030: Morbidity shifts in an aging society. Scientific Reports (2019).
2. Oral health and use of dental services in different stages of adulthood in Norway: a cross sectional study. BMC Oral Health (2021).
3. Oral health status among 60-year-old individuals born in 1941–1943 and 1954–1955 and 81-year-old individuals born in 1922–1924 and 1933–1934, respectively: a cross-sectional study. Clinical Oral Investigations (2022).