Oral health and dental care in Australia

Maintaining a healthy mouth relies upon practising good oral hygiene. Regular toothbrushing removes and controls the build-up of plaque, and helps to prevent tooth decay, gum disease and tooth loss. In Australia, it is recommended that people brush their teeth twice a day using fluoride toothpaste (Department of Health, Disability and Ageing 2018).

Data presented in this chapter of the report has been sourced from various national population surveys. Whilst all collect information about access to and use of dental services, measures of oral health and barriers to use of dental services, the National Child Oral Health Study 2012–14, the National Survey of Adult Oral Health 2004–06 and the National Study of Adult Oral Health 2017–18 all included a clinical examination component whereas the National Dental Telephone Interview Survey collects self-reported information. As such, even though there is some overlap of measures, data from these surveys is presented separately to distinguish between the two collection methods.

Oral hygiene status

An accumulation of dental plaque, typically due to poor oral hygiene practices such as not brushing your teeth properly or regularly, can increase the risk of tooth decay. Data presented in this section were sourced from the National Child Oral Health Study 2012–14 (Do & Spencer 2016) which included a clinical examination component.

The proportion of children aged 5–14 years with a moderate accumulation of plaque was:

• higher for boys (48%) than girls (37%)
• higher for Indigenous children (60%) than non-Indigenous children (42%)
• lower for children from high income households (35%) than from low income households (49%)
• lower for children from Major cities (39%) than from Remote and very remote (63%) areas
• lower for children who last visited the dentist for a check-up (40%) than those who visited for a dental problem (50%).

Gingivitis

Gingivitis, or early stage gum disease, is usually caused by a build-up of plaque on teeth and along the gum line. The bacteria in plaque produce toxins that can irritate the gums causing inflammation. Data presented in this section were sourced from the National Child Oral Health Study 2012–14 (Do & Spencer 2016), the National Survey of Adult Oral Health 2004–06 (Slade et al. 2007) and the National Study of Adult Oral Health 2017–18 (Do & Luzzi, 2019) which all included a clinical examination component.

In 2012–14, the proportion of children aged 5–14 years with gingivitis was:

• lower for girls (20%) than boys (24%)
• higher for Indigenous children (34%) than non-Indigenous children (21%)
• higher in children from low-income households (26%) than from high-income households (17%)
• higher for children from Remote and very remote (38%) than from Major cities (20%)
• lower for children who last visited the dentist for a check-up (21%) than those who visited for a dental problem (25%).

In 2017–18, the proportion of adults aged 15 years and over with gingivitis was:

• higher for males (35%) than females (23%)
• higher for people without dental insurance (31%) than those with dental insurance (25%)
• higher for people eligible for public dental care (30%) than those ineligible for public dental care (28%).

Periodontitis

If left untreated, gingivitis can develop into a more serious form of gum disease known as periodontitis. Periodontitis, or advanced stage gum disease, damages the soft tissue and bone supporting the teeth which can cause the teeth to become loose, which in turn can lead to tooth loss. Data presented in this section were sourced from the National Survey of Adult Oral Health 2004–06 (Slade et al. 2007) and the National Study of Adult Oral Health 2017–18 (Do & Luzzi, 2019) which both included a clinical examination component.

In 2017–18, the proportion of adults aged 15 years and over with moderate or severe periodontitis was:

• higher for males (35%) than females (26%)
• nearly twice as high for those people who had completed Year 10 or less of schooling (45%) than those who had completed Year 11 or more of schooling (26%)
• almost 1.5 times as high for people who last visited the dentist for a problem (37%) than those who last visited for a check-up (26%)
• higher for those people eligible for public dental care (43%) than those people ineligible for public dental care (26%).

Tooth retention and loss

Tooth loss can affect both oral function and appearance, and therefore negatively impact on quality of life. Limited oral function is also associated with deteriorating diet and compromised nutrition, which can adversely impact on overall health (NACDH 2012).

Children with missing teeth

The data presented were sourced from the National Child Oral Health Study 2012–14 (Do & Spencer 2016), which included a clinical examination component, and reflect teeth lost due to dental decay only, and therefore do not include teeth lost due to exfoliation or dental trauma (for example, as a result of injury).

Children aged 5–10 years with at least one deciduous tooth missing due to dental caries were more likely to be:

• Indigenous Australians (9.7%) than non-Indigenous Australians (5.3%)
• from Remote and very remote areas (9.6%) than from Major cities (4.9%)
• from low-income households (9.3%) than from medium-income households (4.3%) and high-income households (2.9%)
• those who last visited the dentist for a dental problem (17%) than those who last visited for a check-up (3.5%).

Children aged 6–14 years with at least one permanent tooth missing due to dental caries were more likely to be:

• female (1.0%) than male (0.5%)
• Indigenous Australians (1.4%) than non-Indigenous Australians (0.7%)
• those who last visited the dentist for a dental problem (1.4%) than those who last visited for a check-up (0.6%).

Adults with missing teeth

The data presented in this section were sourced from the National Survey of Adult Oral Health 2004–06 (Slade et al. 2007) and the National Study of Adult Oral Health 2017–18 (Do & Luzzi, 2019) which both included a clinical examination component. Adults who have no natural teeth are classified as edentulous, whereas those who have at least one natural tooth are classified as dentate. Only dentate adults were assessed for inadequate dentition (fewer than 21 teeth).

In 2017–18:

• The average number of missing teeth increased with age, ranging from 0.6 teeth in 15–34 year olds, 3.6 teeth in 35–54 year olds, 8.8 teeth in 55–74 year olds to 13.2 teeth in those aged 75 years and over.
• On average, adults who completed Year 10 or less of schooling had more than twice as many missing teeth as those who completed Year 11 or more of schooling, 7.7 and 3.3 respectively.
• The average number of missing teeth for adults eligible for public dental care (7.6) was more than double that of those ineligible for public dental care (3.0).

In 2017–18:

• On average, 1 in 10 (10%) adults aged 15 years and over had inadequate dentition.
• Adults eligible for public dental care (24%) were around five times as likely to have inadequate dentition than those ineligible for public dental care (4.7%).
• Adults who completed Year 10 or less of schooling (21%) were around four times as likely to have inadequate dentition than those who completed Year 11 or more of schooling (5.9%).
• Adults who had inadequate dentition were more likely to have last visited the dentist for a dental problem (18%) rather than for a check-up (6%).

In 2017–18:

• On average, 1 in 25 (4.0%) adults aged 15 years and over had complete tooth loss.
• Adults eligible for public dental care (11%) were around nine times as likely to suffer complete tooth loss than those ineligible for public dental care (1.2%).
• Adults who completed Year 10 or less of schooling (9.4%) were around five times as likely to suffer complete tooth loss than those who completed Year 11 or more of schooling (1.8%).
• Adults without dental insurance (6.5%) were more likely to suffer complete tooth loss than those with dental insurance (1.7%).

Healthy mouths across Australia

In this section measures of oral health status in adults aged 15 years and over, such as periodontal disease and tooth retention and loss, are compared across states and territories. Data presented were sourced from the National Survey of Adult Oral Health 2004–06 (Slade et al. 2007; AIHW 2008a–h) and the National Study of Adult Oral Health 2017–18 (Do & Luzzi, 2019) which both included a clinical examination component.

Explore the data for Healthy mouths by state and territory further:

Self-reported measures of oral health

The data presented in this section was sourced from the National Dental Telephone Interview Survey 2021 (Luzzi et al. 2023) which included measures of self-reported oral health status, use of and access to dental services, social impact of oral health, financial burden of dental care and private health insurance that covered dental expenses. There was no clinical component to the survey.

• The proportion of adults who reported they had gum disease ranged from 7.1% in 18–34 year olds to 15% in 55–74 year olds.
• Around twice as many adults who usually visited the dentist for a dental problem (18%) reported they had gum disease than those who usually visited the dentist for a check-up (8.7%).

• The proportion of adults who reported having an inadequate dentition increased with age, with around 4 in 10 (37%) adults aged 75 years and over reporting they had an inadequate dentition.
• Around 1 in 4 (23%) adults eligible for public dental care reported they had an inadequate dentition compared to around 1 in 25 (3.8%) adults ineligible for public dental care.
• The proportion of adults reporting they had an inadequate dentition decreased over time, from 19% in 1994 to 7.5% in 2021.

• The proportion of adults who reported complete tooth loss increased as remoteness increased, ranging from 3.0% in Major cities to 4.6% in Inner regional areas and 5.7% in Outer regional and remote areas.
• Around twice as many adults without dental insurance (4.9%) reported complete tooth loss than those with dental insurance (2.3%).
• The proportion of adults reporting they had complete tooth loss decreased over time, from 13% in 1994 to 3.0% in 2021.

Explore the data further in the interactives below.