DT News - UK - Society’s poorest have eight fewer teeth

Dental Tribune International

Thu. 20 November 2014

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NEWCASTLE, UK: The poorest people in society have eight fewer teeth by their seventies than the richest, one of the largest studies of its type ever undertaken has found. The research, a collaboration between Newcastle University, the Newcastle upon Tyne Hospitals NHS Foundation Trust, University College London (UCL) and the National Centre for Social Research, showed that oral health is substantially worse among the poorest 20 per cent of society compared with the most wealthy. For those over 65 years old, the least well off averaged eight fewer teeth than the richest—a quarter of a full set of teeth.

More than 6,000 people aged 21 and over from all income groups and regions of the UK, excluding Scotland, were involved in the study, which was funded by the Economic and Social Research Council and used data from the recent UK Adult Dental Health Survey. Those with lower income, higher deprivation and lower educational attainment, and in a lower occupational class generally had the worst clinical outcomes, including increased tooth decay, periodontal disease, and diastemas, as well as fewer teeth overall.

Despite these social differences, oral health is improving and the oral health of young British adults overall is much better than it used to be. However, previously published research by the same team showed that, while the youth had much healthier mouths than did their predecessors, when asked how good or bad their own oral health was and how it affected them, the social divisions between rich and poor were evident, and even more pronounced than in older people. The poorest young people were very aware of their poor health and much more likely than the wealthiest to rate their oral health as poor or say that it affected their day-to-day life.

Mix of reasons for poor oral health

Prof. Jimmy Steele, CBE, Head of the School of Dental Sciences at Newcastle University and lead author, said: “It’s probably not a big surprise that poorer people have worse dental health than the richest, but the surprise is just how big the differences can be and how it affects people. Eight teeth less on average is a huge amount and will have had a big impact for these people. From our data it is hard to say which specific factors are driving each of the differences we are seeing here, but there is probably a real mix of reasons and it is not just about, for example, the availability of treatment.”

“Although the younger generation have much better oral health than their parents ever did, the differences between rich and poor are very considerable and young people are particularly aware when they do not have a healthy mouth. The risk is that as health gets better overall the differences just get greater and poorer people lose out.”

Dr Georgios Tsakos, senior lecturer at the Research Department of Epidemiology and Public Health at UCL, added: “In terms of the younger adults, we showed that it is not only being poor that affects their perceptions about their oral health and quality of life, but educational attainment can also make a major difference. This has profound implications for policy, as intervening in earlier life could have a significant long-term effect on oral health.”

Inequalities in oral health require urgent action

Dr John Wildman, Professor of Health Economics at Newcastle University Business School, the principal investigator on the Economic and Social Research Council study, said: “Inequalities in oral health have not received the attention that they deserve. Our study is an attempt to redress this balance. Oral health contributes hugely to everyday wellbeing and addressing these inequalities may result in considerable improvements in quality of life for large numbers of individuals.”

Prof. Richard Watt, Head of the Research Department of Epidemiology and Public Health at UCL, commented on the important policy implications of this research: “Inequalities in oral health require urgent action by organisations such as Public Health England—in particular more needs to be done to tackle the underlying causes of oral diseases such as sugary diets.”

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