Not much to smile about: two new reports highlight dental inequities
Posted 26/10/2012 by Amanda Biggs
Two new dental reports provide a timely overview of the oral health of those with chronic illnesses compared to the broader population, and on the oral health of children and their families.
The Australian Institute of Health and Welfare (AIHW) publication Chronic conditions and oral health reveals disparities in oral health between people with a chronic condition and those without. The publication reports on a survey that measured five oral health impacts: toothache, discomfort with appearance of teeth or mouth, avoidance of some foods due to tooth problems, experience of broken or chipped teeth, and oral facial pain. Two measures of tooth loss were also reported: average number of missing teeth and inadequate dentition (fewer than 21 teeth).
Chronic conditions include asthma, cancer, heart disease, diabetes, arthritis/osteoporosis, stroke, high blood pressure, kidney disease and depression. The report found that 46.9 per cent of those surveyed had one or more chronic conditions. People with a chronic condition also tended to be older than those without a chronic condition.
Those with a chronic condition reported toothache, discomfort with their oral appearance or avoided of some foods due to oral problems at twice the rate as those without a chronic condition. Those with a chronic condition were also more likely to report facial pain and have an inadequate number of teeth. Both groups displayed similar dentist visiting patterns, with around a third reporting they had visited a dentist for a check-up in the last year. Any differences attributable to age or sex were minimised through the application of statistical standardisation methods.
Of those with a chronic condition, people with stroke had the highest average number of missing teeth, and were most likely to have inadequate dentition and to have avoided some foods due to oral problems.
The report confirms that people with chronic illnesses remain more likely than those without such conditions to report a range of poor dental health characteristics, including toothache and missing teeth. These findings may add weight to arguments that because the clinical needs of people with chronic conditions are greater than those without such conditions, dental policies that target their needs, such as the soon to be closed Chronic Disease Dental Scheme are warranted.
The second report also by AIHW, Families and their oral health provides information on the dental health of Australian children and shows how closely this is related to the dental health of their parents. Some 16.7 per cent of children surveyed had experienced dental problems, such as toothache and or avoidance of some foods in the previous year. In families where children had such dental problems, some 23.2 per cent of their parents reported similar dental problems over the same period. Conversely, for children who reported having no dental problems during the last year, 86.1 per cent of their parents also had no dental problems.
The report also found that the oral health of children and dental affordability were linked. Families who reported they would have a problem paying a $150 dental bill had a greater proportion of children with a dental problem compared to those who said they could afford to pay a dental bill. Children whose parents avoided or delayed a dental visit due to cost were also more likely to report having a dental problem, compared to others who did not. Families in the lowest income categories also had a greater proportion of children with toothache compared to those in the higher income categories.
The report shows the links between the dental status of children and their parent’s and how access to dental services is also linked to parental income levels. This would suggest that to be effective, dental policies may need to focus on economic disparities and affordability of dental services.
Together, these reports can be seen as timely reminders of the disparities that exist between different groups in terms of their dental health. They may add weight to calls for increased funding for dental health of children of lower income families as well as those with chronic conditions. It remains to be seen if the recently announced Dental Reform package, will be sufficient to fully address these inequities.
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