OBJECTIVES To assess the overall dentition status of American adults, to investigate disparities and changes in dentition using the National Health and Nutrition Examination Surveys 2005-2006 and 2007-2008 and to study the effects of family poverty status, education, citizenship and language on dentition after adjusting for other demographics. METHODS Descriptive statistics were used to explore and summarise dentition status. The prevalence of dentition markers over two surveys were compared using tests of proportions and a series of regressions were used to estimate the strength of association of family poverty status, education, citizenship and language with the four markers of dentition status. RESULTS Overall, dentition status has improved in adults. However, gaps exist in that non-Hispanic Black and Mexican-Americans have a higher prevalence of dental decay and lower restoration rates than other races. After adjusting for selected demographics, adults with less education (<12 years) and lower family income had significantly higher dental decay rates, lower restoration rates and more missing teeth than those with more education (≥12 years) and those with higher family incomes. CONCLUSION This study indicates that disparities in dentition associated with race/ethnicity, education and income still exist among adults in the USA. The results also indicate that to improve overall oral health and close the existing gaps in oral health, increased access to dental care would be needed for people who have low incomes and low levels of education.