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.

Explore the data further in Healthy lives interactives 1 & 2:

Healthy lives – Interactive 1

This figure shows the social impacts of oral health for adults aged 15 years and over, by selected characteristics. National data is presented for 2017–18. In Australia, 23.7% of adults aged 15 years and over avoided foods due to dental problems in 2017–18.

Healthy lives – Interactive 2

This figure shows the proportion of people rating their oral health as fair or poor, for dentate adults aged 15 years and over. National data is presented for 2004–06 and 2017–18. In Australia, 23.9% of adults aged 15 years and over rated their oral health as fair or poor in 2017–18.

See Data tables: Healthy lives for data tables.

Burden of disease

Oral disorders cause very few deaths, yet are highly prevalent in the Australian community. The Australian Burden of Disease Study 2018 (AIHW 2021) estimated the burden of dental caries and pulpitis, periodontal disease and severe tooth loss (fewer than 10 teeth).

In 2018, oral disorders made up 2.4% of total health burden and 4.5% of all non-fatal burden. Oral disorders did not contribute to fatal burden.

For children aged 5–14, dental caries was among the top 10 causes of non-fatal burden for both boys and girls (AIHW 2021).

Changes in non-fatal burden (YLD) rates are influenced by changes in the prevalence and/or the severity of the disease. After adjusting for ageing of the population, the age-standardised rate of oral disorders remained stable between 2003 and 2018. However, the age-standardised rate of periodontal disease increased by 40% between 2003 and 2018 (AIHW 2021).

The data presented in Interactive 3 reflects the progression of untreated dental disease across the life stages. In 2018:

  • The relative proportion of non-fatal burden due to dental caries decreased with age from 99% in children aged 0–1­4 years to 14% in those aged 85 and over.
  • Half of non-fatal burden due to oral disorders in people aged 85 years and over was due to severe tooth loss (51%), followed by periodontal disease (35%).

Explore the data further in Healthy lives interactive 3:

Healthy lives – Interactive 3

This figure shows the proportion of non-fatal burden (YLD) due to oral disorders, by age group and oral disorder. National data is presented for 2011, 2015 and 2018. In Australia, 23% of non-fatal burden (YLD) due to oral disorders was attributed to severe tooth loss in 2018.

See Data tables: Healthy lives for data tables.

Oral cancers

Cancer was the leading cause of total disease burden in Australia in 2018 (AIHW 2021b). 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, along with other factors such as the effectiveness of treatment.

In Australia, the 5-year relative survival rate in 2013–2017 for all selected oral cancers was 76%, compared to 70% for all cancers combined

  • Between 1988–1992 and 2013–2017 the 5-year relative survival for selected oral cancers increased from 69% to 76%.

  • In 2013-2017, the 5-year relative survival for selected oral cancers varied from 62% for cancer of the mouth to 94% for cancer of the lip.

  •  In 2017, there were 3,329 cases of selected oral cancers, including 1,005 cases of cancer of the tongue making it the most common oral cancer in this group.

  • In 2017, there were 622 deaths from selected oral cancers, including 213 deaths from cancer of the tongue.

Explore the data using the interactives below:

Healthy lives – Interactive 4

This figure shows the five-year relative survival for selected oral cancers, by sex and cancer site. National data is presented for 2013–2017. In Australia, all selected oral cancers had a relative five-year survival rate of 76.4% in 2013–2017.

Healthy lives – Interactive 5

This figure shows the age-standardised five-year relative survival trend for selected oral cancers, by sex. National data is presented for 1988–1992 to 2013–2017. Between 1988–1992 and 2013–2017 the five year relative survival for selected oral cancers increased from 69% to 76%.

Healthy lives – Interactive 6

This figure shows the incidence, mortality and age-standardised rate of each for selected oral cancers, by sex and cancer site. National data is presented for 2017. In Australia, there were 3,329 cases of oral cancer in 2017.

See Data tables: Healthy lives for data tables.

References

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.

Australian Institute of Health and Welfare 2021a. Australian Burden of Disease Study: Impact and causes of illness and death in Australia 2018., AIHW, Australian Government. doi:10.25816/5ps1-j259

Australian Institute of Health and Welfare 2021b. Cancer in Australia 2021., AIHW, Australian Government. doi:10.25816/ye05-nm50