Survey fills middle-age health gap
THE average middle-aged Scot has more than 10 fillings and only 14 healthy teeth, a new survey has revealed. However, the study of 3,114 adults over the age of 45 found that two-thirds had a functional dentition; enough teeth – more than 21 – to lead a normal daily life.
The Scottish Adult Oral Health Survey (SAOHS) was initially carried out as a pilot project in 2015/16 with the approval and support of the Scottish Dental Epidemiology Co-ordinating Committee.
The aim was to assess the feasibility of conducting a survey of adult oral health across Scotland, within an age-defined group of people attending primary dental care for an examination appointment. If successful, it would be the first stage in the development of a rolling SAOHS programme for different age groups.
A web-based oral health data collection system was developed by National Services Scotland (NSS), which allowed dentists to record levels of adult oral health and directly transfer this information safely and securely to the Information Services Division (ISD)
of NHS Scotland for analysis.
ISD worked closely with dentists and other staff from NHS boards, NHS Education for Scotland, and the Universities of Glasgow and Dundee to pilot this new method as a means of collecting routine adult oral health information. The survey was repeated in 2017/18 and recruited further dentists – 126 in all – to provide a representative sample across NHS boards and deprivation categories.
It concluded that “collecting survey data in relation to the oral health and behaviour of patients aged 45 years and over as part of a primary dental care examination is feasible”.
The long-term purpose of the survey, said ISD, is to “record levels of adult oral health across Scotland in order to inform policy, plan services, improve and maintain health, and to monitor changes over time”.
Although the survey was principally testing an alternative approach for gathering epidemiological data, it was also designed to provide a picture of oral health for an under-reported cohort of the population, adults aged 45 years and over.
Michael McGrady, NHS Greater Glasgow and Clyde’s consultant in dental public health, said that oral health programmes had focused on children and the elderly and, until now, very little had been known about the teeth of those aged in between.
He told The Times Scotland: “The very simple message we can take from this, as adults, is don’t forget about your dental health. Eat well, brush your teeth twice a day with a fluoride toothpaste and make sure you get regular check-ups. Things have definitely improved on 20 years ago so we are going in the right direction and it’s a good start for us to build on.”
The survey’s main points included:
- Anxiety: 971 men (70%) and 938 women (55%) reported not experiencing any anxiety about visiting a dentist.
- Attendance: 1,207 men (86%) and 1,517 women (88%) reported attending a dentist at least once within the last year.
- Dentate status: 2,998 (96%) patients had at least one natural tooth.
- Functional dentition: 2,019 (67%) had 21 or more natural teeth.
- Sound untreated teeth: Mean number was 14.
- Decayed teeth: Across dentate patients, the mean number was 0.5 for males and 0.4 for females.
- Filled teeth: Across dentate patients examined, the mean number was 10.4 for men and 10.8 for women.
- Artificial crowns: 633 men (47%) and 855 women (52%) had at least one crown.
- Bridges, veneers, and implants: 13% of dentate patients had at least one bridge, 5% had at least one veneer, and 2% had at least one dental implant.
- Oral hygiene: 445 men (33%) and 464 women (28%) had a score of 2 or 3 (with 3 indicating debris/plaque covering more than two-thirds of the tooth surface).
- Basic periodontal examination (BPE): 395 men (29%) and 420 women (25%) had a highest sextant BPE score of 3 or 4.
- Dentures: 974 (31%) reported wearing a denture of some type.
- Soft tissue examination: 288 patients (9%) had one or more types of soft tissue lesion identified, with a total of 331 lesions recorded. No potentially malignant lesions were noted for those patients examined.