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 2013 National Dental Telephone Interview Survey 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 (AIHW 2016b).

Experience of toothache

Around 1 in 6 (16%) 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 those whose annual household income was less than $30,000 (24%) than those whose annual household income was $140,000 or more (9%)
  • higher for those eligible for public dental care (20%) than those ineligible for public dental care (15%)
  • higher for those from Remote and very remote areas (22%) than those from Inner regional areas (15%)
  • lower for people with dental insurance (12%) than those without dental insurance (20%).

Uncomfortable with dental appearance

Around 1 in 4 (27%) 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 (23%) than females (31%)
  • higher for dentate adults (27%) than edentulous adults (22%)
  • higher for those whose annual household income was less than $30,000 (33%) than those whose annual household income was $140,000 or more (18%)
  • higher for those eligible for public dental care (33%) than those ineligible for public dental care (25%)
  • lower for people with dental insurance (23%) than those without dental insurance (31%).

Food avoidance

Around 1 in 5 (21%) 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 (18%) than females (24%)
  • higher for edentulous adults (34%) than dentate adults (20%)
  • higher for those whose annual household income was less than $30,000 (32%) than those whose annual household income was $140,000 or more (11%)
  • higher for those eligible for public dental care (29%) than those ineligible for public dental care (18%)
  • lower for people with dental insurance (17%) than those without dental insurance (25%).
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Social impact trends

The proportion of adults aged 15 years and over reporting any oral health impact in the previous 12 months fluctuated between surveys, but generally increased over the period from 1994 (31%) to 2013 (39%).

Similar trends were observed over the same time period for:

  • experience of toothache
  • feeling uncomfortable with dental appearance
  • avoiding certain foods.

The proportion of children aged 5–14 years reporting any oral health impact in previous 12 months fluctuated between surveys, and ranged between 10% in 2002 to 16% in 2005; in 2013, the proportion was 15%.

Similar trends were observed over the same time period for:

  • experience of toothache
  • avoiding certain foods.
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Burden of disease

Oral disorders cause very few deaths, yet are highly prevalent in the Australian community. The Australian Burden of Disease Study 2011 (AIHW 2016a) estimated the burden of dental caries and pulpitis, periodontal disease and severe tooth loss (fewer than 10 teeth).

In 2011, oral disorders made up 2.2% of total health burden, 0.02% of all fatal burden and 4.4% of all non-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 in people aged 85 years and over was due to severe tooth loss (78%).
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Oral cancers

Cancer was the leading cause of total disease burden in Australia in 2011 (AIHW 2017). 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 (ICD-10 C00-C10) 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.

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. Five-year relative survival statistics for selected oral cancers are presented here.

In 2013, there were 3,277 cases of selected oral cancers, including 1,047 cases of lip cancer making it the most common oral cancer in this group.

  • In Australia, the 5-year relative survival in 2009­–2013 for all selected oral cancers was 74%, compared to 68% for all cancers combined.
  • In 2009–2013, the 5-year relative survival for selected oral cancers varied from 58.8% for mouth cancer to 92.9% for lip cancer.
  • Between 1984­–1988 and 2009–2013, the 5-year relative survival for lip cancer remained relatively unchanged, and improved for mouth and tongue cancer.
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References

  • AIHW (Australian Institute of Health and Welfare) 2016a. Australian Burden of Disease Study: Impact and causes of illness and death in Australia 2011. Australian Burden of Disease Study series no. 3. Cat. no. BOD 4. Canberra: AIHW.
  • AIHW: Chrisopoulos S, Harford JE & Ellershaw A 2016b. Oral health and dental care in Australia: key facts and figures 2015. Cat. no. DEN 229. Canberra: AIHW.
  • AIHW 2017. Cancer in Australia 2017. Cancer series no. 101. Cat. no. CAN 100. Canberra: AIHW.