The Big Picture

Prevalence of toothlessness

Background

The end stage of dental caries and periodontitis is edentulism. This state not only diminishes the patient’s quality of life but has been shown in some studies to predict mortality. Monitoring the prevalence of edentulism has been undertaken by some countries, with many reporting declines in recent times, although the reasons for this remain unclear. A study was undertaken to quantify the trends in edentulism prevalence in US adults over the course of 5 decades, to describe variations in

Methods

The population trends were tracked using data from five national surveys that covered 1957-1958, 1971-1975, 1988-1998, 1999-2002, and 2009-2012. The individuals included were at least age 15 years. Birth cohort analysis was used to isolate the effects of age and cohort. A sixth 2010 survey of adults was used to investigate the geographic and sociodemographic variations in the prevalence of edentulism.

Results

From the 1957-1958 survey to the 2009-2012 survey, edentulism prevalence fell from 18.9% to 4.9% (Fig 1). Generations born before the 1940s had a rate of edentulism incidence of 5% to 6% per decade of age, which was substantially higher than the 1% to 3% per decade of age found in cohorts born later.

Analysis showed that edentulism is now rarely seen in high-income households. Asian individuals have a markedly lower prevalence than any other racial group. Educational attainment is inversely

Discussion

Today and in the future, edentulism is more likely to be concentrated in low-income households in states that have a long history of poverty. These areas have suffered a loss of jobs in farming, forestry, and manufacturing and have unemployment rates higher than the national average. As a result, the use of dental care is also lower than in more affluent areas. Thus sociodemographic status factors as well as population trends affect the rates of edentulism.