Wealth and location determines oral health

Guess how wealthy he is?
Guess how wealthy he is?

People with lower household income and people living in regional and remote areas generally have poorer oral health than other Australians, according to new information published on the Australian Institute of Health and Welfare (AIHW) website this week.

The update to the AIHW’s Dental and oral health web pages shows that both dental health and dental visiting patterns are affected by remoteness and socioeconomic status.

The proportion of people with untreated decay was greater in Remote/Very remote areas (38 per cent) than in Major cities (24 per cent).

“In 2004-06, adults living in Inner regional areas had the highest measure of poor oral health, which is defined as the average number of decayed, missing or filled permanent teeth (DMFT) at 14.75,” said AIHW spokesperson Dr Adrian Webster.

Similar patterns were also seen in dental visiting, with adults in Major cities the most likely to have visited a dentist for a check-up at least once in the past 12 months (49 per cent of adults).
This compares to just 31 per cent of people living in Remote/Very remote areas.

Most dentists work in Major cities (79.7 per cent of all employed dentists), while only 0.9 per cent were in Remote/Very remote areas (0.9 per cent). Major cities also had the highest rates of dentists and dental hygienists, while Remote/Very remote areas had the lowest rates of all dental practitioners, except dental therapists.

“Visiting patterns also varied by household income. Under one-third (28 per cent) of adults in the lowest income group had visited a dentist for a check-up in the last 12 months, compared to over half of those in the highest income group (56 per cent),” Dr Webster said.

People in higher income households generally have lower rates of untreated decay as well as fewer missing teeth, compared to those in lower income households.

“The proportion of people with untreated decay was highest for those with household income of less than $12,000 per year, and the lowest where household income was $100,000 or more,” Dr Webster said.

People living in lower income households went to the dentist less often than those in higher income households.

Half of those with a household income of less than $12,000 per year had visited the dentist in the previous year (50 per cent), compared to two-thirds of those with a household income of at least $100,000 (67 per cent).

Around one-third of the lower income group hadn’t visited the dentist at all in the past 2 years (34%), compared to less than one-fifth (16 per cent) of the higher income group.

Survey data from 2010 shows more than one-quarter of people aged 5 or older (28 per cent) avoided or delayed visiting a dentist due to cost. From 1994 to 2010, there was a rise in the proportion of adults avoiding dental visits, from about 25 per cent to 30 per cent. For children, the overall trend was unchanged at around 14 per cent, but varied between 8.5 per cent and 17 per cent over this period.

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  1. High levels of dental neglect are related to level of education which also relates to level of income. In other words high levels of dental neglect begin with a low level of education and not, as some rural dental schools suggest, a lack of access to dental treatment.
    In any case, dental treatment is not the same as dental care which again relates to level of education.
    These statistics reflect the fact that people in rural and remote areas have lower education levels – you don’t need a degree to drive a tractor.
    Unfortunately, Dental schools in rural areas use these statistics to gain their funding and add to the oversupply of dentists which in turn leads to overtreatment. Unfortunately this has the opposite effect to the minimum intervention and prevention that is so important in dental care as dentists try to maintain their incomes in an oversupplied market.

  2. The solution to dental decay is indeed related to remoteness – not remoteness from the Big City – but remoteness from the bathroom sink and toothbrush. Dental disease is a disease of neglect. If more people realised how lack of brushing would affect their sex life then we would have more fanatical brushers Dr Jeremy Rourke http://www.health.gov.au/internet/nhhrc/publishing.nsf/Content/188-interim/$FILE/188 – Submision – Dr Jeremy Rourke.pdf


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