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Oral health

Introduction

Australians enjoy a high standard of oral health. However, there are inequalities, with higher rates of dental caries among people with higher levels of socioeconomic disadvantage, people living in rural and remote areas, indigenous people, people born overseas, and people from older generations. There is also differential access to dental services according to country of birth, indigenous status, language spoken at home, health insurance status, socioeconomic status, and educational status.[1]

According to the 2004-06 National Survey of Adult Oral Health, there have been improvements in oral health, particularly among the 'fluoride generation' born since 1970; however, there is a population divide in the pattern of dental care, between those who have regular visits to a dental professional and those who visit a dental professional infrequently or only when they have an oral health problem. The latter group is worse off on almost all measures of oral health.[2]

Regular visits to a dental professional, at least once every 2 years, have a significant and positive effect on dental health. Those who visit a dental care professional regularly have significantly less severity and prevalence, and suffer fewer social and psychological effects, of dental health problems.[3,4]

Fluoridation of drinking water reduces dental caries. It is carried out under the provisions of the Fluoridation of Public Water Supplies Regulation 2002 and the Fluoridation of Public Water Supplies Act 1957. Under the Act, water supply authorities are responsible for fluoridating water, for daily testing of fluoride concentration, and for submitting results of testing to the NSW Department of Health.[5,6]

In 2006, the New South Wales Population Health Survey asked respondents: Are any of your natural teeth missing? Do you have dentures or false teeth? When did you last visit a dental professional about your teeth, dentures or gums? Respondents who had not seen a dental professional in the last 12 months were asked: What are the main reasons for you not visiting the dentist in the last 12 months? Respondents were also asked: Has fluoride been added to your water supply? Do you agree with adding fluoride to your public water supply to try and prevent tooth decay? or, Would you be in favour of adding fluoride to your water supply to try and prevent tooth decay: In children, In adults, In both children and adults? Where have you received information on water fluoridation? and, Who should decide on the fluoridation of water supplies?

Results

Visits to dental professionals

Overall, in 2006, 58.1 per cent of adults visited a dental professional less than 12 months ago, 17.1 per cent one to less than 2 years ago, 12.6 per cent 2 to less than 5 years ago, 5.8 per cent 5 to less than 10 years ago, 5.5 per cent 10 years ago or more, and 0.9 per cent had never visited a dental professional.

A significantly higher proportion of females (59.8 per cent) than males (56.4 per cent) visited a dental professional less than 12 months ago. Among males, a significantly higher proportion of adults aged 45-54 years (64.5 per cent), and a significantly lower proportion of adults aged 25-34 years (48.3 per cent), visited a dental professional in the last 12 months, compared with the overall adult male population. Among females, a significantly higher proportion of adults aged 45-54 years (67.5 per cent), and a significantly lower proportion of adults aged 25-34 years (51.5 per cent) and 75 years and over (52.1 per cent), visited a dental professional in the last 12 months, compared with the overall adult female population.

A significantly lower proportion of adults in rural areas (53.0 per cent) than urban areas (60.3 per cent) visited a dental professional in the last 12 months. A higher proportion of adults in the Northern Sydney & Central Coast Health Area (67.0 per cent), and a lower proportion of adults in the Greater Southern (50.6 per cent) and Greater Western (46.7 per cent) Health Areas, visited a dental professional in the last 12 months.

Visits to a dental professional decreased with socioeconomic disadvantage. A higher proportion of adults in the least disadvantaged quintile (68.3 per cent), and a lower proportion of adults in the 2 most disadvantaged quintiles (53.8 per cent and 48.6 per cent), visited a dental professional less than 12 months ago. The proportion of adults who visited a dental professional in the last 12 months increased significantly between 2002 (55.8 per cent) and 2006 (58.1 per cent).

The principle reasons for not visiting a dental professional in the last 12 months include: do not need to (48.0 per cent), too expensive (26.0 per cent), hard to find time (15.6 per cent), and worried or afraid of going (13.4 per cent).

Retention of natural teeth

Overall, in 2006, 4.8 per cent of adults had all their natural teeth missing. A significantly higher proportion of females (5.9 per cent) than males (3.7 per cent) had all their natural teeth missing, and in both sexes the proportion increased significantly with age. The proportion of adults with all their natural teeth missing was significantly higher in rural areas (7.1 per cent) than urban areas (3.8 per cent). A higher proportion of adults in the North Coast (6.8 per cent), Greater Southern (7.0 per cent), Greater Western (7.0 per cent), and Hunter & New England (7.3 per cent) Health Areas had all their natural teeth missing, compared with the overall adult population. A lower proportion of adults in the Northern Sydney & Central Coast (3.1 per cent) and Sydney South West (3.5 per cent) Health Areas had all their natural teeth missing, compared with the overall adult population. The proportion of adults with all their natural teeth missing increased with socioeconomic disadvantage. A lower proportion of adults in the least disadvantaged quintile (2.8 per cent), and a higher proportion of adults in the most disadvantaged quintile (6.1 per cent), had all their natural teeth missing, compared with the overall adult population.

The proportion of adults with all their natural teeth missing decreased significantly from 1998 (8.2 per cent) to 2006 (4.8 per cent).

Attitude towards fluoridation of public water supplies

Overall, 79.5 per cent of adults said their public water supply had been fluoridated, and 86.1 per cent of adults agreed with having their water supply fluoridated. There was no significant variation between males and females. A significantly higher proportion of adults 65-74 years (88.7 per cent) and 75 years and over (88.7 per cent) agreed with having their water supply fluoridated. A significantly lower proportion of adults in rural areas (80.1 per cent) than urban areas (88.8 per cent) agreed with having their water supply fluoridated. A higher proportion of residents in the South Eastern Sydney & Illawarra (90.9 per cent) and Northern Sydney & Central Coast (89.0 per cent) Health Areas, agreed with having their water supply fluoridated. A lower proportion of adults in North Coast (72.6 per cent) and Greater Southern (80.5 per cent) and Greater Western (77.7 per cent) Health Areas agreed with having their water supply fluoridated, compared with the overall adult population. A higher proportion of adults in the least disadvantaged quintile (90.0 per cent) and a lower proportion of adults in the second most disadvantaged quintile (82.6 per cent) agreed with having their water supply fluoridated, compared with the overall adult population.

There was no significant variation in the proportion of adults who agreed with having their water supply fluoridated between 2005 and 2006.

Information about water fluoridation came from a wide variety of sources: newspapers (23.1 per cent), television (16.8 per cent), health authorities (13.5 per cent), magazines (5.8 per cent), radio (5.5 per cent), dentists (5.3 per cent), advertisements for dental products (1.4 per cent), and dental auxiliaries (8.3 per cent).

Adults felt that decisions on the fluoridation of water supplies should be made by: health authorities (31.3 per cent), the community (36.2 per cent), the state government (23.4 per cent), dental associations (16.8 per cent), and water boards (12.1 per cent).

References

  1. Australian Institute of Health and Welfare Dental Statistics and Research Unit. Oral Health and Access to Dental Care: 1994–1996 and 1999. Adelaide: Australian Institute of Health and Welfare Dental Statistics and Research Unit, 2001.
  2. Australian Institute of Health and Welfare Dental Statistics and Research Unit. Australia's dental generations: The National Survey of Adult Oral Health 2004-06. Adelaide: Australian Institute of Health and Welfare Dental Statistics and Research Unit, 2007. Available online at www.adelaide.edu.au/spdent/dsru/pub_frame.html (accessed 10 May 2007).
  3. Kay EJ. Do regular attenders have better oral health? Br Dent J 2002; 193(12): 697-702. Available online at www.nature.com/bdj/journal/v193/n12/full/4801663a.html (accessed 10 May 2007).
  4. Richards W and Ameen J. The impact of dental attendance on oral health in a general dental practice. Br Dent J 2002; 193(12): 697-702. Available online at www.nature.com/bdj/journal/v193/n12/full/4801664a.html (accessed 10 May 2007).
  5. National Health and Medical Research Council. 2004 Australian Drinking Water Guidelines. Canberra: NHMRC, 2004. Available online at www.nhmrc.gov.au/publications/synopses/eh19syn.htm (accessed 10 May 2007).
  6. The Sydney Water Corporation website at www.sydneywater.com.au (accessed 10 May 2007).

Graphs

Source: New South Wales Population Health Survey 2006 (HOIST). Centre for Epidemiology and Research, NSW Department of Health.
Print version: Although this page can be printed directly from your web browser, a higher quality version is available as a PDF file that can be printed or viewed on screen.
Produced by: Centre for Epidemiology and Research, Population Health Division, NSW Department of Health.
Last updated on: 1 July 2007

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