Healthy mouths

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 (DoH 2018).

Key terms

  • Plaque: A biofilm containing bacteria and food debris that adheres to the tooth surface.
  • Plaque index: A measure of plaque from 0–3, devised by Loe & Silness (1964), where:
    0 = no plaque
    1 = mild accumulation of plaque
    2 = moderate accumulation of plaque
    3 = abundant accumulation of plaque.
  • Gingivitis: Redness, swelling or bleeding of the gums caused by inflammation.
  • Gingival index: A measure of gingivitis from 0–3, devised by Loe & Silness (1963), where:
    0 = normal
    1 = mild inflammation (no bleeding on probing)
    2 = moderate inflammation (bleeding on probing)
    3 = severe inflammation (tendency to spontaneous bleeding).
  • Periodontitis: Inflammation of the gums and other tissues that attach to and anchor teeth to the jaws, caused by a bacterial infection.
  • Exfoliation: The process of shedding deciduous teeth and their replacement by permanent teeth.
  • Dentate: Having one or more natural teeth.
  • Edentulous: A state of complete loss of all natural teeth.
  • Inadequate dentition: Fewer than 21 natural teeth. 

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).

Around 4 in 10 (43%) of children aged 5–14 years had a moderate accumulation of plaque.

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) and the National Survey of Adult Oral Health 2004–06 (Slade et al. 2007).

Around 1 in 5 (22%) children aged 5–14 years had gingivitis.

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%).

Around 1 in 5 (20%) adults aged 15 years and over had gingivitis.

The proportion of adults aged 15 years and over with gingivitis was:

  • higher for Indigenous adults (27%) than non-Indigenous adults (20%)
  • higher for people without dental insurance (23%) than those with dental insurance (16%)
  • higher for people eligible for public dental care (24%) than those ineligible for public dental care (18%).

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).

The proportion of adults with moderate or severe periodontitis increased with age, ranging from 7.4% in 15–34 year olds, 25% in 35–54 year olds, 44% in 55–74 year olds and 61% in those aged 75 years and over.

The proportion of adults aged 15 years and over with moderate or severe periodontitis was:

  • higher for males (27%) than females (19%)
  • nearly twice as high for those people who had completed Year 9 or less of schooling (39%) than those who had completed Year 10 or more of schooling (21%)
  • 1.5 times as high for people who last visited the dentist for a problem (28%) than those who last visited for a check-up (19%)
  • higher for those people eligible for public dental care (34%) than those people ineligible for public dental care (20%).

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) 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).

Around 1 in 20 children aged 5–10 years have at least one deciduous tooth missing due to dental caries.

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

  • Indigenous (9.7%) than non-Indigenous (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%).

Around 1 in 100 children aged 6–14 years have as least one permanent tooth missing due to dental caries.

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 (1.4%) than non-Indigenous (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). 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).

Dentate adults aged 15 years and over had an average of 4.5 teeth missing due to dental decay and periodontal disease.

  • The average number of missing teeth increased with age, ranging from 0.8 teeth in 15–34 year olds, 3.9 teeth in 35–54 year olds, 10.2 teeth in 55–74 year olds to 14.1 teeth in those aged 75 years and over.
  • On average, adults who completed Year 9 or less of schooling had more than twice as many missing teeth as those who completed Year 10 or more of schooling, 9.0 and 4.0, respectively.
  • The average number of missing teeth for adults eligible for public dental care (7.6) was around double that of those ineligible for public dental care (3.5).

The proportion of adults with in adequate dentition (fewer than 21 teeth) increased with age, ranging from 0.4% in 15–34 year olds to 55% in those aged 75 years and over.

  • On average, around 1 in 10 (11%) adults aged 15 years and over had inadequate dentition. 
  • Adults eligible for public dental care (27%) were around four times as likely to have inadequate dentition than those ineligible for public dental care (6.7%).
  • Adults who completed Year 9 or less of schooling (34%) were around four times as likely to have inadequate dentition than those who completed Year 10 or more of schooling (8.6%).
  • Adults who had inadequate dentition were twice as likely to have last visited the dentist for a dental problem (16%) rather than a check-up (7.8%).

The proportion of adults with complete tooth loss increased with age, ranging from 1.7% in 35–54 year olds, 14% in 35–54 year olds to 36% in those aged 75 years and over. There were no 15–34 year olds with complete tooth loss.

  • On average, 1 in 15 (6.4%) adults aged 15 years and over had complete tooth loss.
  • Adults eligible for public dental care (17%) were around six times as likely to suffer complete tooth loss than those ineligible for public dental care (2.7%).
  • Adults who completed Year 9 or less of schooling (22%) were around five times as likely to suffer complete tooth loss than those who completed Year 10 or more of schooling (4.1%).
  • Adults without dental insurance (9.4%) were around three times as likely to suffer complete tooth loss than those with dental insurance (3.1%)

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–2008h).

The measure of oral health status with the greatest variation between states and territories was complete tooth loss, with around four times as many adults with complete tooth loss in Tasmania (10.0%) than in the Northern Territory (2.4%).

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

References

  • AIHW (Australian Institute of Health and Welfare) Dental Statistics and Research Unit 2008a. The National Survey of Adult Oral Health 2004–06: Australian Capital Territory. Cat. no. DEN 175. Dental Statistics and Research series no. 39. Canberra: AIHW.
  • AIHW Dental Statistics and Research Unit 2008b. The National Survey of Adult Oral Health 2004–06: New South Wales. Cat. no. DEN 176. Dental Statistics and Research series no. 40. Canberra: AIHW.
  • AIHW Dental Statistics and Research Unit 2008c. The National Survey of Adult Oral Health 2004–06: Northern Territory. Cat. no. DEN 177. Dental Statistics and Research series no. 41. Canberra: AIHW.
  • AIHW Dental Statistics and Research Unit 2008d. The National Survey of Adult Oral Health 2004–06: Queensland. Cat. no. DEN 178. Dental Statistics and Research series no. 42. Canberra: AIHW.
  • AIHW Dental Statistics and Research Unit 2008e. The National Survey of Adult Oral Health 2004–06: South Australia. Cat. no. DEN 179. Dental Statistics and Research series no. 43. Canberra: AIHW.
  • AIHW Dental Statistics and Research Unit 2008f. The National Survey of Adult Oral Health 2004–06: Tasmania. Cat. no. DEN 180. Dental Statistics and Research series no. 44. Canberra: AIHW.
  • AIHW Dental Statistics and Research Unit 2008g. The National Survey of Adult Oral Health 2004–06: Victoria. Cat. no. DEN 181. Dental Statistics and Research series no. 45. Canberra: AIHW.
  • AIHW Dental Statistics and Research Unit 2008h. The National Survey of Adult Oral Health 2004–06: Western Australia. Cat. no. DEN 182. Dental Statistics and Research series no. 46. Canberra: AIHW.
  • DoH (Department of Health) 2018. Healthdirect—Teeth cleaning. Canberra: Australian Government Department of Health. Viewed 26 September 2018.
  • Do LG & Spencer AJ (editors) 2016. Oral health of Australian children: the National Child Oral Health Study 2012–14. Adelaide: University of Adelaide Press.
  • NACDH (National Advisory Council on Dental Health) 2012. Report of the National Advisory Council on Dental Health 2012. Canberra: Department of Health and Ageing.
  • Slade GD, Spencer AJ, Roberts-Thomson KF (Editors) 2007. Australia’s dental generations: the National Survey of Adult Oral Health 2004–06. Dental statistics and research series no. 34. AIHW cat. no. DEN 165. Canberra: AIHW.