• Overview
• Definition
• Incidence, prevalence and trends
• Risk factors
• Health consequences
• Costs
• Contributors

Incidence, Prevalence and Trends

National surveys conducted in the UK have shown considerable improvements in oral health in the past 30 years. For example, according to the UK Adult Dental Health Survey, the proportion of adults in all UK countries who have lost all their natural teeth had dropped from 30% in 1978 to 21% in 1988 and 13% in 1998. ¹

Adults

More adults now keep their teeth for life. In 1968, 37% of adults in England had no natural teeth; by 1998 this figure had fallen to 11%. In Wales, the number of dentate adults with 21 or more teeth increased from 71% in 1978 to 81% in 1998. In Northern Ireland, the percentage of adults with no natural teeth, dropped from 18% in 1988 to 12% in 1998. ¹

However, the number of adults with no teeth in all UK countries is still high. In 1998 12% of adults in England, 17% of adults in Wales, 18% of adults in Scotland and 12% of adults in Northern Ireland were without teeth. ¹

In 1998 adults in England had the healthiest teeth in the UK, with over 40% of dentate adults having 18 or more sound or untreated teeth. This compares with 37% in Wales, 29% in Scotland and 31% in Northern Ireland. ¹

Children

The oral health of children in England is the best since records began. In the early 1970s, around 30% of children started school with no experience of tooth decay; by 2003, this figure had risen to 59%. ²

The proportion of older children with decayed, missing, or filled (DMFT) permanent teeth has also dropped. In 1973, 93% of 12 year old children had tooth decay in England; by 2003, this had fallen to a historic low of 38%.

Obvious dental decay in the permanent teeth of 8, 12 and 15 year old children has decreased since 1983 to its lowest recorded level. ²

In Scotland, a national survey in 2000 revealed high levels of poor health among the most disadvantaged communities. By the age of 3, over 60% of children from areas of deprivation have dental disease. By the age of 5, over 56% of all Scottish children have dental disease. By the time they are 14, 68% of children have suffered from dental caries in their adult teeth. ³

Socio-economic group

There is a strong association between oral health and social disadvantage. People in social classes III, IV and V are three times more likely to have lost all their teeth than those in classes I & II. ³

Other developed countries

In other developed countries, the picture of incidence, prevalence and trends is similar.

In Australia for example, despite a significant reduction in dental caries in children over the last 20-30 years, only some of this improvement has carried through to adulthood. There are persistent high levels of oral disease and disability among Australian adults. ⁴ Dental caries is Australia’s most prevalent health problem: dental caries and periodontal disease account for 90% of all tooth loss. ⁵

Poor oral health in Australia is most evident among Aboriginal and Torres Strait Islander peoples, people on low incomes, rural and remote populations, and some immigrant groups from non-English speaking backgrounds, particularly refugees. ⁵ The oral health gains have been experienced disproportionately by those at the upper end of the socio-economic scale, and there has been increased polarisation of dental caries within the community. ⁶

Recent trends suggest that there has been a deterioration in children’s oral health. Notably, there was a 21% increase in tooth decay in 5 year olds between 1996 and 1999. ⁷ Children in low socio- economic groups experience almost twice as much decay as those in high socio-economic groups. ⁵ Even higher rates are seen among Aboriginal and Torres Strait Islander children, who experience about twice as much caries as non-indigenous children; and their oral health has continued to worsen over recent decades, in contrast to the improvements among their non-indigenous counterparts.