Social Inequality: Social inequality in perceived oral health among adults in Australia

Abstract

Objective: To establish population estimates of self‐assessed tooth loss and subjective oral health and describe the social distribution of these measures among dentate adults in Australia. Methods: Self‐report data were obtained from a nationally representative sample of 3,678 adults aged 18–91 years who participated in the 1999 National Dental Telephone Interview Survey and completed a subsequent mail survey. Oral health was evaluated using (1) self‐assessed tooth loss, (2) the 14‐item Oral Health Impact Profile, and (3) a global six‐point rating of oral health. Results: While the absolute difference in tooth loss across household income levels increased at each successive age group (18–44 years, 45–64 years, 65+ years) from 0.7 teeth to 6.1 teeth, the magnitude of the difference was approximately twofold at each age group. For subjective oral health measures, the magnitude of difference across income groups was most pronounced in the 18–44 years age group. In multivariate analysis, low household income, blue‐collar occupation, and high residential area disadvantage were positively associated with social impact from oral conditions and pathological tooth loss. Speaking other than English at home (relative to English), low household income (relative to high income), and vocational relative to tertiary education were each associated with more than twice the odds of poor self‐rated oral health. Conclusions: Significant social differentials in perceived oral health exist among dentate adults. Inequalities span the socio‐economic hierarchy. Implications: In addition to improving overall levels of oral health in the adult community, goals and targets should aim to reduce social inequalities in the distribution of outcomes.

Greater Inequalities in Dental Treatment than in Disease Experience

“…Our stratified results reflect these generational differences. The results of the analyses agree with previous reports in which there were large differences in missing teeth by age, with much steeper social gradients in older age groups (Sanders and Spencer, 2004). Likewise, the differences by age groups with regard to DMFT were also large.…”

“…Wamala and colleagues (2006) reported that increased levels of socio-economic disadvantage were associated with decreased use of dental services and poorer oral health among Swedish adults. Previous research in Australia demonstrated income inequalities with regard to edentulism (Sanders and Spencer, 2004), while in the United Kingdom, social gradients with respect to untreated dental disease in both children and adults have been reported (Watt and Sheiham, 1999).…”

Dental fear in Australia: who's afraid of the dentist?

“…This method has been previously shown to have good reliability. 31 In both arches, people with high fear had more teeth missing than people with low fear and conversely, therefore, fewer teeth remaining than people with low fear (Fig 4). These results were statistically significant for both the maxillary (F=26.3,…”

Government subsidies for dental care in Australia

“…Oral diseases exhibit a social gradient. 9,10 Hence the shift from the CDHP to the 30% rebate also represented a shift from funding dental care services for those with the greatest oral health care needs to those with moderate or low need. This represents a shift in funding from population subgroups that had the potential to achieve significant gains in oral health status, to Restrict 30% rebate for all singles and $31.5m families on incomes of less than $100,000 per year those that would produce modest gains.…”