Healthy lives

As described in the Introduction, oral health can impact an individual’s general health and wellbeing. Good oral functioning enables comfortable participation in everyday activities.

Key terms

  • Dentate: Having one or more natural teeth.
  • Edentulous: A state of complete loss of all natural teeth.
  • Incidence: The number of new cases (of an illness or injury) occurring during a given period.
  • Burden of disease (and injury): The quantified impact of a disease or injury on a population, using the disability-adjusted life years (DALY) measure. Referred to as the ‘burden’ of the disease or injury in this report.
  • DALY (disability-adjusted life years): Measure (in years) of healthy life lost, either through premature death defined as dying before the expected life span at the age of death (YLL) or, equivalently, through living with ill health due to illness or injury (YLD).
  • Fatal burden: The burden from dying ‘prematurely’ as measured by years of life lost. Often used synonymously with YLL, and also referred to as ‘life lost’.
  • YLL (years of life lost): Years of life lost due to premature death, defined as dying before the ideal life span at the age of death. YLL represent fatal burden.
  • Non-fatal burden: The burden from living with ill health as measured by years lived with disability. Often used synonymously with YLD, and also referred to as ‘health lost’.
  • YLD (years lived with disability): A measure of the years of what could have been healthy but were instead spent in states of less than full health. YLD represent non-fatal burden.
  • International Classification of Diseases (ICD): The World Health Organization’s internationally accepted classification of diseases and related health conditions. The tenth revision, Australian modification (ICD-10-AM) is currently in use in Australian hospitals for admitted patients.
  • Relative survival: The ratio of observed survival of a group of persons diagnosed with cancer to expected survival of those in the corresponding general population after a specified interval following diagnosis (such as, 5 or 10 years).

Social impacts of poor oral health

Measures of social impact give insight into the effect of oral conditions on day-to-day living from the individual’s perspective. Experience of social impact reflects not only the level of oral disease experienced, but also whether that disease had been treated in a timely fashion. The following data were sourced from the National Study of Adult Oral Health 2017–18 in which people are asked about their experience of toothache, how they feel about their dental appearance and whether or not they avoid eating certain foods (Brennan et al 2019).

Experience of toothache

Around 1 in 5 (20%) dentate adults aged 15 years and over had experienced toothache in the previous 12 months.

The proportion of adults aged 15 years and over who experienced toothache in the previous 12 months was:

  • higher for Indigenous Australians (35%) than non-Indigenous Australians (20%)
  • higher for those eligible for public dental care (26%) than those ineligible for public dental care (18%)
  • higher for those who usually visit the dentist for a problem (34%) than those who usually visit for a check-up (12%)
  • lower for people with dental insurance (15%) than those without dental insurance (26%).

Uncomfortable with dental appearance

Around 1 in 3 (35%) dentate adults aged 15 years and over had felt uncomfortable about their dental appearance in the previous 12 months

The proportion of adults aged 15 years and over who had felt uncomfortable about their dental appearance in the previous 12 months was:

  • lower for males (32%) than females (38%)
  • higher for Indigenous Australians (45%) than non-Indigenous Australians  (35%)
  • higher for dentate adults (36%) than edentulous adults (29%)
  • higher for those who usually visit the dentist for a problem (49%) than those who usually visit for a check-up (28%)
  • higher for those eligible for public dental care (40%) than those ineligible for public dental care (33%)
  • lower for people with dental insurance (30%) than those without dental insurance (41%).

Food avoidance

Around 1 in 4 (24%) dentate adults aged 15 years and over had avoided eating certain foods in the previous 12 months due to problems with their teeth

The proportion of adults aged 15 years and over who had avoided eating certain foods in the previous 12 months due to problems with their teeth was:

  • lower for males (20%) than females (27%)
  • higher for edentulous adults (43%) than dentate adults (23%)
  • higher for Indigenous Australians (36%) than non-Indigenous Australians (23%)
  • higher for those eligible for public dental care (33%) than those ineligible for public dental care (20%)
  • lower for people with dental insurance (17%) than those without dental insurance (31%)
  • higher for those with Year 10 or less schooling (29%) than those with Year 11 or more (21%).

Perception of fair or poor oral health

Around 1 in 4 (24%) dentate adults aged 15 years and over rated their oral health as fair or poor

The proportion of adults aged 15 years and over who rated their oral health as fair or poor was:

  • lower for females (23%) than males (25%)
  • higher for Indigenous  Australians (29%) than non-Indigenous Australians (24%)
  • higher for those eligible for public dental care (32%) than those ineligible for public dental care (21%)
  • lower for people with dental insurance (16%) than those without dental insurance (33%)
  • higher for those with Year 10 or less schooling (30%) than those with Year 11 or more (22%)
  • higher for those who usually visit the dentist for a problem (44%) than those who usually visit for a check-up (13%).

Social impact trends

The proportion of dentate adults aged 15 years and over reporting their oral health as fair or poor increased from 16% in 2004–06 to 24% in 2017–18. The proportion of dentate adults aged 15 years and over reporting their oral health as fair or poor increased from 16% in 2004–06 to 24% in 2017–18

A similar trend was observed over the same time period for:

  • those aged 55–64, with the proportion of people rating their oral health as fair or poor increasing from 18% in 2004–06 to 32% in 2017–18.

Burden of disease

Oral disorders cause very few deaths, yet are highly prevalent in the Australian community. The Australian Burden of Disease Study 2015 (AIHW 2019a) estimated the burden of dental caries and pulpitis, periodontal disease and severe tooth loss (fewer than 10 teeth).

In 2015, oral disorders made up 2.3% of total health burden and 4.5% of all non-fatal burden. Oral disorders did not contribute to fatal burden

The data presented in Interactive 3 reflects the progression of untreated dental disease across the life stages:

  • The relative proportion of non-fatal burden due to dental caries decreased with age from 99% in children aged 0–1­4 years to 7% in those aged 85 and over
  • The vast majority of non-fatal burden due to oral disorders in people aged 85 years and over was due to severe tooth loss (78%).

Oral cancers

Cancer was the leading cause of total disease burden in Australia in 2015 (AIHW 2019b). Treatment can be more effective when cancer is detected early, and dental practitioners play an important role in this. Cancer of the lip, tongue, mouth, salivary glands and oropharynx are those cancers that are detectable in an oral examination by a dental practitioner. Early detection is one of the factors associated with better cancer survival.

High five-year relative survival is used as a proxy measure of early detection because population-level data on the stage at diagnosis of oral cancers are not currently available.

In Australia, the 5 year relative survival rate in 2011–2015 for all selected cancers was 75%, compared to 69% for all cancers combined

  • Between 1986–1990 and 2011–2015 the five year relative survivial for selected oral cancers increased from 66% to 73%.
  • In 2011–2015, the 5-year relative survival for selected oral cancers varied from 60% for cancer of the mouth to 93% for cancer of the lip.
  • In 2015, there were 3,407 cases of selected oral cancers, including 935 cases of cancer of the lip making it the most common oral cancer in this group.
  • In 2015, there were 674 deaths from selected oral cancers, including 231 deaths from cancer of the tongue.

References

Australian Institute of Health and Welfare 2019a. Australian Burden of Disease Study: impact and causes of illness and death in Australia 2015. Cat. No. BOD 22. Canberra: AIHW. doi:10.25816/5ebca2a4fa7dc

Australian Institute of Health and Welfare 2019b. Cancer in Australia 2019. Cat. no. CAN 123. Canberra: AIHW. doi:10.25816/5ebcc7a7fa7e9

Brennan DS, Luzzi L, Ellershaw A, Peres M 2019. Oral health perceptions pp125–144. In: ARCPOH. Australia’s Oral Health: National Study of Adult Oral Health 2017–18. Adelaide: The University of Adelaide, South Australia.