Trends in paediatric dental caries by poverty status in the United States, 1988–1994 and 1999–2004


Bruce Dye, DDS, MPH, CDC/NCHS/NHANES Programme, 3311 Toledo Road, Room 4416, Hyattsville, MD 20782, USA. E-mail:


International Journal of Paediatric Dentistry 2010; 20: 132–143

Background.  Recent reports have suggested that dental caries among some young children is increasing in the United States.

Aim.  To describe changes in paediatric caries prevalence by poverty status in the United States.

Design.  National Health and Nutrition Examination Survey (NHANES) data for children aged 2–11 years for 1988–1994 and 1999–2004 were used.

Results.  Caries in the primary dentition increased among poor and non-poor boys aged 2–8 years (45–53% and 23–31%, respectively) and among non-poor boys aged 2–5 years (13–21%) from 1988–1994 to 1999–2004. Caries experience also increased on buccal-lingual, mesio-distal, and occlusal primary dental surfaces among poor children aged 2–8 years and this increase may be attributed to an increase in the number of dental surfaces restored. In the mixed dentition, caries remains relatively unchanged. Caries continues to decline in the permanent dentition for many children, but is increasing among poor non-Hispanic whites aged 6–8 years (8–22%) and poor Mexican-Americans aged 9–11 years (38–55%).

Conclusions.  For many older children, caries continues to decline or remain unchanged. Nevertheless, for a subgroup of younger children, caries is increasing and this increase is impacting some traditionally low-risk groups of children.