Caries is a ubiquitous non-communicable disease worldwide. There is a paucity of literature on adult caries in Africa, with the last epidemiological caries study in South Africa conducted in 1988/1989. This article reports on the decayed, missing and filled teeth (DMFT) scores in relation to demographic characteristics for a mixed-ancestry South African population.This cross-sectional epidemiological study was part of the ongoing Cape Town Bellville South Vascular and Metabolic Health Study. Each participant signed an informed consent form prior to enrolling in the study. During a clinical examination, DMFT score and components were recorded for each participant. Data analysis was performed with the statistical Package STATA 15.A sample of 1,885 participants was included in the study. Sixty-eight percent of the population experienced high DMFT scores. Mean DMFT score increased with age from 5 (≤ 24-year-old group) to 32 (≥ 75-year-old group, P < 0.001). It was higher in women than in men (28.5 vs. 18, respectively, P < 0.001). The missing component contributed 83% to DMFT score, followed by decayed (14%) and filled (3%) scores. Males had a higher average number of teeth present than females (18 vs. 6.5, P < 0.001).Dental caries experience was very high, with high levels of tooth loss in this community. These findings highlight limited access to preventive oral healthcare and a high rate of tooth extraction. Females presented higher levels of oral disease than males, indicating the need for preventive oral healthcare programmes in Cape Town, South Africa.