The New York Times and Oral Health

Today’s New York Times runs a story headlined Boom Times for U.S. Dentists, But Not for Americans’ Teeth:

Previously unreleased figures from the Centers for Disease Control and Prevention show that in 2003 and 2004, the most recent years with data available, 27 percent of children and 29 percent of adults had cavities going untreated. The level of untreated decay was the highest since the late 1980s and significantly higher than that found in a survey from 1999 to 2002.

The data used have been previously published only in a different format than that presented in this story.

Clearly, untreated tooth decay is an important issue. The percentages of untreated decay reported in the Times article do capture the magnitude of the problem. However, when you compare the estimates from 1988-1994 with 1999-2004, previous CDC reports show that the trend for untreated decay has not changed significantly. It’s worth noting that estimates from shorter time periods have greater variation than when you use a longer time period.

Background:

• For children age 2-11 years, the Vital and Health Statistics Series 11 Report from CDC reported that approximately 23% had untreated decay in their baby teeth during 1988-1994 and 1999-2004.
• The NYT report of 27% (for primary teeth in children aged 2-11 years) covers a 2 year period from 2003-04. Two-year data periods have greater variation in the estimates compared to the smoothing effects of six-year data periods. Although the 27% derived from 2003-04 is larger compared to 22% (1999-2002) obtained from an earlier MMWR report published by the CDC, it is unknown if greater variation between the two smaller data periods (1999-2002 and 2003-2004) would produce a difference that would be statistically significant.
• Similar issues are present for adults. The Series 11 Report from CDC reported that approximately 25% adults age 20-64 years had untreated decay during 1999-2004 with 28% of 35-44 year-olds experiencing untreated decay during the same period. The previously mentioned MMWR (August 2005) reported that 23% of adults aged 20 years and older had untreated decay during 1999-2002.

Untreated tooth decay is an important issue, with approximately 1 out of 4 adults having untreated decay. The NYT report of 29% adults having untreated decay during 2003-2004 is greater compared to earlier published data from the CDC, but the issues of how the effect of greater variation among the estimates for smaller time intervals of data remains.