Trends in Dental Implant Use in the U.S., 1999–2016, and Projections to 2026

Abstract

Dental implants have become an increasingly popular treatment choice for replacing missing teeth. Yet, little is known about the prevalence and sociodemographic distribution of dental implant use in the United States. To address this knowledge gap, we analyzed data from 7 National Health and Nutrition Examination Surveys from 1999 to 2016. We estimated dental implant prevalence among adults missing any teeth for each survey period overall as stratified by sociodemographic characteristics. We calculated absolute and relative differences from 1999-2000 to 2015-2016 and fit logistic regression models to estimate changes over time. We also used multivariable logistic regression to estimate independent associations of sociodemographic covariates with the presence of any implant. We projected the proportion of patients treated with dental implants into the year 2026 under varying assumptions of how the temporal trend would continue. There has been a large increase in the prevalence of dental implants, from 0.7% in 1999 to 2000 to 5.7% in 2015 to 2016. The largest absolute increase in prevalence (12.9%) was among individuals 65 to 74 y old, whereas the largest relative increase was ~1,000% among those 55 to 64 y old. There was an average covariate-adjusted increase in dental implant prevalence of 14% per year (95% CI, 11% to 18%). Having private insurance (vs. none or public insurance) or more than a high school education (vs. high school or less) was each associated with a 2-fold increase in prevalence, with an almost 13-fold (95% CI, 8 to21) increase for older adults. Dental implant prevalence projected to 2026 ranged from 5.7% in the most conservative scenario to 23% in the least. This study demonstrates that dental implant prevalence among US adults with missing teeth has substantially increased since 1999. Yet access overall is still very low, and prevalence was consistently higher among more advantaged groups.

Income or education, which has a stronger association with dental implant use in elderly people in Japan?

“…Additionally, our study's prevalence is similar to the prevalence reported in previous studies in other countries. For example, in a recent study from the USA, the prevalence of dental implant use rose from 0.7% in 1999 to 2000 to 5.7% in 2015 to 2016. In Switzerland, the prevalence of dental implant use in 2002 was 4.4%.…”

“…Our results are consistent with the results of three previous studies from the USA. Those studies reported an increase in the odds ratio for dental implant use among the higher SES groups. However, none of these studies examined the association of income level as a predictor of dental implant use.…”

“…The average cost of a single tooth implant in Japan ranges from ‘3,000 to 6,000 USD’, with annual maintenance fees ranging from ‘30 to 100 USD’, depending on where treatment takes place. Social inequalities in dental implant use have been previously reported in a few studies from the USA. However, these studies could not measure income inequality in dental implant use.…”

“…Although a rise in the demand and use of dental implant treatment services has been reported in Sweden and the USA, the higher treatment cost associated with these services is likely to cause strong income inequalities. The treatment costs of dental implants are higher than those of conventional therapy such as endodontic treatment and complete and partial denture treatments.…”

“…However, these studies could not measure income inequality in dental implant use. Two studies used geographical location (zip code) as a proxy for socioeconomic status (SES), and one study used educational attainment as an indicator of SES. Because income is considered to be directly related to the payment for implant treatment, inequalities in income should be directly measured.…”