The prevalence of dental sealants in the US population: findings from NHANES III, 1988-1991.

Over the past decade, dental sealants have become recognized as an important adjunct to the use of fluorides in the prevention of dental caries. The most recent national survey of oral health in children conducted in 1986-1987 found that only 7.6% of children had any sealed teeth. As part of the oral health component of the 1988-1991 Third National Health and Examination Survey (NHANES III-Phase 1), the prevalence of dental sealants in children, adolescents, and adults was determined. The presence of dental sealants on posterior teeth (excluding third molars) and maxillary lateral incisors was recorded by visual and tactile methods during the dental caries examination. Findings in this paper are based on those examined persons having at least one sealable primary tooth for children aged 2-11 years (n=3,792); at least one sealable premanent tooth for persons aged 18 years and over (n=7,146). During 1988-1991, about 18.5% of US children and youth ages 5-17 had one or more sealed permanent teeth. A significantly higher percentage of non-Hispanic whites had sealants in comparison with their non-Hispanic black and Mexican-American counterparts (for all contrasts, p<0.001). As expected, molar teeth were the most frequently sealed tooth type. Only 1.4% of US children ages 2-11 had at least one sealed primary tooth. The prevalence of dental sealants decreased in the US adult population with increasing age; 5.5% of adults ages 18-24 had at least one sealed permanent tooth. Data collected from NHANES III-Phase 2 (1991-1994) will be analyzed to determine if the upward trend in sealant use continues.

Tooth retention and tooth loss in the permanent dentition of adults: United States, 1988-1991.

While the overall prevalence of tooth loss and edentulism has been declining in the United States over the past several decades, important variations remain among subgroups of the population. Data from Phase 1 of the Third National Health and Nutrition Examination Survey (NHANES III) provide the most current estimates of the prevalence and distribution of tooth retention and tooth loss in the United States. Weighted analyses were conducted for all adults 18+ years of age (n=8,366) and for selected age, gender, and race-ethnicity groups. In 1988-91, 89.5% of the population was dentate, and 30.5% had retained all 28 teeth. The mean number of teeth retained was 21.1 for all adults and 23.5 for dentate persons. The most commonly retained teeth in the mouth were the six anterior teeth in the lower arch. Conversely, 10.5% of the population was edentulous. Partial edentulism was much more common in the upper arch than in the lower arch. The most commonly missing teeth were the first and second molars. Age was strongly related to every measure of tooth retention and tooth loss. Gender was not related to any of these measures, after adjustment for age. Race-ethnicity was consistently related to these measures, after adjustment for age and gender. In general, Mexican-Americans had the lowest and black non-Hispanics the highest rates of tooth loss. Future research needs to examine a wide range of potential correlates of tooth retention and tooth loss before we can understand the complex interplay among the personal, dental, and environmental factors influencing tooth retention and tooth loss in the United States.