Poorest in society have eight fewer teeth
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- Published: Tuesday, 25 November 2014 07:35
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The poorest people in society have eight fewer teeth by their seventies than the richest, one of the biggest studies of its type ever undertaken has revealed. Lead author, Professor Jimmy Steele: “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.”
It has long been known that there is a strong link between people’s socioeconomic position and their oral health, but the new paper published in the Journal of Dental Research has shown the full extent of the problem.
Oral health can be measured in many ways but this study, a collaboration between Newcastle University, Newcastle upon Tyne NHS Foundation Trust, UCL and the National Centre for Social Research, showed it was substantially worse among the poorest 20% of society compared with the richest for all of the measures the research team used. This has potential knock on effects to others areas of health. 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 (not Scotland) were involved in the study, funded by the ESRC with data taken from the recent UK Adult Dental Health Survey. Those with lower income, lower occupational class, higher deprivation and lower educational attainment generally had the worst clinical outcomes, including having more tooth decay, gum disease, and tooth gaps, as well as having less 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 whilst the young had much healthier mouths than 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 very evident, and even more pronounced than in older people. The poorest young people were very aware of their poor health and much more likely to rate their oral health as bad or say that it affected their day to day life than the wealthiest.
Professor Jimmy Steele CBE, Head of the Dental School 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.”
The British Dental Association (BDA) has respeonded by urging government to invest in prevention. Dr John Milne, Chair of the BDA’s General Dental Practice Committee, said: “This research is the starkest evidence of a systematic failure to invest in prevention. Governments past and present have been too inclined to view oral health as an 'optional extra', when it is fundamental to our health, wellbeing and confidence. The link between income and oral health is stubborn and starts in childhood. And parents, teachers, healthcare workers and policy makers need to work in partnership to ensure the necessary building blocks are in place from the start of life.
“The tools to break this pattern are neither new nor expensive. Education, fluoridation and sugar controls can all make a difference, and we must ensure dentists have contracts in place that recognise and reward work on prevention.We shouldn’t kid ourselves that today’s research reflects the failure of post-war governments. In 2014 we seeing three-year-olds with missing and decayed teeth. And until government steps up we will continue condemning large swathes or the population to pain, discomfort and expensive and avoidable procedures.”
Research can be found at:
http://jdr.sagepub.com/content/early/2014/10/20/0022034514553978.abstract
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