Adult oral health survey 2021: self-reported health of teeth and gums


Presence and number of natural teeth

Introduction

Information about the presence and number of natural teeth was collected through self-completion questionnaires. Participants were asked if they had any natural teeth and, if so, to count the number of natural teeth in their mouths, counting the upper and lower arches separately. Consequently, these findings are not directly comparable with that collected by interviewers and dental examiners in previous years.

Prevalence of natural teeth

Almost all (95%) of adults (16 years and over) reported having some natural teeth; 5% were edentate, that is they reported that they had no natural teeth.

Sex

Men were more likely than women to report not having any natural teeth (5% and 4% respectively).

Household income

The proportion of adults reporting no natural teeth decreased with household income from 8% in the lowest income quintile to 1% in the highest income quintile.

Figure 1: proportion who said they have no natural teeth, by household income

Base: all adults.

Error bars show the 95% confidence interval around the estimates.

Source: Table 1 in the data tables.

Neighbourhood deprivation

The proportion of adults who said they had natural teeth was higher in less deprived neighbourhoods. Those living in the 3 most deprived quintiles were more likely than those living in the 2 least deprived quintiles to report having no natural teeth (between 5% and 8% and between 1% and 3% respectively).  

Figure 2: proportion who said they have no natural teeth, by neighbourhood deprivation

Base: all adults.

Error bars show the 95% confidence interval around the estimates.

Source: Table 1 in the data tables.

There were no statistically significant differences in the proportions of adults with no natural teeth by age or between NHS regions.

Number of natural teeth

Adults reported having a mean number of 25.4 natural teeth. Eighty-four per cent of adults reported having 21 or more natural teeth. Having 21 teeth is generally seen as having a minimum number of teeth that is consistent with a functional dentition.  

Age

Adults aged between 25 and 34 years reported the highest mean number of natural teeth (28.0). The mean number of teeth declined thereafter with age to a mean reported 19.0 teeth among adults aged 75 years and over.

At least 90% of adults aged under 55 years reported having 21 or more natural teeth. This proportion declined among older adults to 52% of those aged 75 years and over.

Figure 3: proportion of adults who reported that they have at least 21 teeth, by age

Base: all adults.

Error bars show the 95% confidence interval around the estimates.

Source: Table 2 in the data tables.

Household income

Among adults in the 2 lowest household income quintiles the mean reported number of natural teeth was 24.4 (lowest quintile) and 24.2 (second lowest quintile). The mean reported number of teeth was higher in higher income households, increasing to 27.5 in the highest income households.

The proportions of adults who said they had 21 or more natural teeth increased by household income, from 79% among those living in the 2 lowest income quintiles to 93% of those in the highest income quintile.

Figure 4: proportion of adults who reported that they have at least 21 teeth, by household income

Base: all adults reporting having natural teeth.

Error bars show the 95% confidence interval around the estimates.

Source: Table 2 in the data tables.

Neighbourhood deprivation

The mean reported number of natural teeth was lowest in the most deprived quintile (24.1) and increased to 26.0 in the fourth quintile and 26.4 in the least deprived quintile.

The proportion of adults with 21 or more natural teeth also increased as deprivation decreased from 78% of adults in the most deprived quintile to 90% in the least deprived quintile.

Usual pattern of dental attendance

The mean reported number of natural teeth was highest for those who attended the dentist for occasional check-ups (26.8) and those who attended for regular check-ups (25.8). It was lower among those who went to the dentist only when they had trouble (23.8) and those who said they had never been to the dentist (22.1).

The pattern was similar for adults who reported that they had 21 or more natural teeth. This was highest among those who attended for occasional check-ups (90%) or for regular check-ups (86%). The proportions were lower among those who said that they went only when they had trouble (77%) and lowest among those who said they had never been to the dentist (70%).

Figure 5: proportion of adults who reported that they had at least 21 teeth, by usual pattern of dental attendance

Base: all adults reporting having natural teeth.

Error bars show the 95% confidence interval around the estimates.

Source: Table 3 in the data tables.

There were no statistically significant differences between men and women in the mean reported number of teeth or the proportion who said they had 21 or more natural teeth.

The mean reported number of natural teeth and proportion of adults who said they had 21 or more natural teeth were similar across NHS regions.

Restorations: fillings and crowns

Introduction

Participants who had any natural teeth were asked to count the number of filled teeth and crowned teeth. They were also asked whether they had any implants and whether they had ever had any root canal treatment.

Prevalence of restored teeth among dentate adults

All results described in this section refer to adults who had natural teeth and are based on self-reporting and not on observation. Most adults reported that they had fillings (80%). Thirty-four per cent reported that they had at least one crowned tooth and 34% reported that they had had a root canal filling.

Adults had on average 4.3 filled teeth and 0.8 crowned teeth.

Sex

Men were less likely to report having crowns (32%) than women (37%). Similarly, 32% of men reported having had a root canal filling, compared with 36% of women.

The average number of crowns was very slightly higher among women (0.9, compared with 0.8 for men).

Age

The proportions of adults who said they had filled teeth increased with age from 47% of those aged between 16 and 24 years to 95% of those aged between 55 and 64 years. The proportion was slightly lower in older age groups.

The proportion who said they had crowned teeth was lowest among adults aged 16 to 24 years (5%) and highest among adults aged 55 years or over (between 54% and 62%).

Figure 6: prevalence of restored teeth, by age

Base: all adults reporting having natural teeth.

Error bars show the 95% confidence interval around the estimates.

Source: Table 4 in the data tables.

The proportions who said they had had root canal filling also increased with age, from 6% of those aged 16 to 24 years to 50% of those aged 55 to 74 years.

The mean reported number of filled teeth increased with age from 1.4 teeth for adults aged 16 and 24 years to between 6.5 and 6.6 for adults aged 55 and 74 years. The youngest age group reported the lowest mean number of crowned teeth (0.1) and the adults aged 65 years and over reported the highest (1.7).

NHS region

The prevalence of restored teeth varied across NHS regions. The proportion who said they had fillings was lowest among those in the North West and London (76%) and highest among those in the South East and the South West (83%).

The proportion of adults who said they had crowns ranged from 30% in the North East and Yorkshire to 40% in the South East.

Those living in the Midlands were least likely to report having had a root canal filling (28%). This proportion was highest among those living in London (41%).

The mean reported number of filled teeth varied from 3.9 in the North West to 4.7 in the South West. The mean reported number of crowns was lowest in the North East and Yorkshire and in the Midlands (0.7) and highest in  the South East (1.0).

Household income

Seventy-four per cent of adults in the lowest income quintile said they had fillings, compared with between 80% and 83% in all other income quintiles.

Figure 7: proportion of adults who said they had filled teeth, by household income

Base: all adults reporting having natural teeth.

Error bars show the 95% confidence interval around the estimates.

Source: Table 4 in the data tables.

The proportion of adults who said they had crowned teeth was lowest in the lowest income quintile (28%) and was highest in the highest income quintile (38%). Crowns are a more costly treatment option, which those in higher income quintiles are more likely to be able to afford.

Twenty-eight per cent of dentate adults in the lowest income quintile reported that they had had a root canal filling, and this proportion varied between 33% and 39% in the other income quintiles with no clear pattern.

The mean reported number of filled teeth varied from 3.5 teeth in the lowest income households to 4.7 teeth in the highest income households.

Neighbourhood deprivation

The prevalence of reported fillings was 72% in the most deprived quintile, increasing to 84% in the least deprived quintile.

Figure 8: proportion of adults who said they had filled teeth, by neighbourhood deprivation

Base: all adults reporting having natural teeth.

Error bars show the 95% confidence interval around the estimates.

Source: Table 4 in the data tables.

There was a similar increase in reported crowns from 27% in the most deprived areas to 39% in the least deprived areas.

Among all adults, the mean reported number of filled teeth increased from 3.5 in the most deprived quintile to 5.1 in the least deprived quintile. Similarly, adults in the most deprived quintile reported the lowest mean number of crowns (0.7) compared with the highest mean number of crowns among adults in the least deprived quintile (1.0).

Usual pattern of dental attendance

Eight-five per cent of adults who attended the dentist for a regular check-up said they had filled teeth, compared with 71% of those who attended for occasional check-ups, 75% who attended only when they had trouble, and 61% of those who said they had never been to the dentist.

There was a similar pattern in the proportion who said they had crowns. Forty-one per cent of adults who attended for regular check-ups had crowned teeth, compared with 21% of those who attended for occasional check-ups, 26% of those who only went to the dentist when they had trouble, and 19% who said they had never visited a dentist.

Figure 9: prevalence of restored teeth, by pattern of dental attendance

Base: all adults reporting having natural teeth.

Error bars show the 95% confidence interval around the estimates.

Source: Table 5 in the data tables.

Thirty-seven per cent of adults who said that they attended for regular check-ups and 34% of adults who said they only went to the dentist when they had trouble reported having had a root canal filling, compared with 26% of those who attended for occasional check-ups, and 22% who said they had never been to the dentist.

The average reported number of filled teeth varied from 4.9 among adults who went to the dentist for regular check-ups to 2.8 teeth among adults who said they never went to the dentist. Those who went for regular check-ups also had more crowns on average, 1.0, compared with 0.5 or 0.6 for other adults.

Similar proportions of men and women said they had fillings. The average reported number of filled teeth was similar for men and women.

Variation by neighbourhood deprivation in the proportion of adults who reported that they had had root canal treatment was not statistically significant.

A similar pattern of variation in the mean reported number of crowns were reported across household income quintiles.

Prosthetics: fixed bridges, dentures, implants

Introduction

Participants were asked to report whether they had fixed bridges, dentures or implants.

Fixed bridges

Participants reporting having any natural teeth were asked whether they had fixed bridges replacing teeth in either their upper or lower jaw. Seven per cent of adults said they had, including 5% who had a fixed bridge in their upper jaw only, 1% who had a fixed bridge in their lower jaw only and 1% who had a fixed bridge in their upper and lower jaw.

Age

The prevalence of bridges increased with age. The proportion of adults who said they had a fixed bridge increased from 1% of those aged 16 to 24 years to 17% of those aged 75 years and over.

The proportion of adults with a fixed bridge was similar between men and women and across NHS regions and neighbourhood deprivation. There was no statistical significance in the variation by household income.

Dentures

All survey participants were asked whether they had a denture replacing one or more teeth in their upper jaw and lower jaw. Eleven per cent of adults reported that they had a denture, including 7% who reported they had a denture in their upper jaw only, 3% who had a denture in their upper and lower jaw and 1% who reported they had a denture in their lower jaw only.

Age

The proportion of adults reporting they had a denture was lowest among adults aged 16 to 24 years (1%) and highest among adults aged 75 years and over (39%).

Figure 10: proportion of adults reporting having a denture, by age

Base: all adults.

Error bars show the 95% confidence interval around the estimates.

Source: Table 9 in the data tables.

Household income

Adults in the 3 lower income quintiles were more likely to say they had a denture. This was reported by 11% of adults in the lowest income quintile, 18% in the second lowest quintile and 9% in the third income quintile, compared with 6% of those in the second highest income quintile and 5% in the highest income quintile.

Neighbourhood deprivation

The proportions of adults who said they had a denture varied with neighbourhood deprivation from 9% in the least deprived quintile to 14% in the most deprived quintile.

The proportion of participants with a denture was similar between men and women and across NHS regions.

Implants

Survey participants with natural teeth were asked whether they had any implants and 5% of adults reported that they did.

Age

The proportion of adults who said they had implants increased with age, from less than 1% of those aged 16 to 24 years to 8% of those aged 55 years and over.

NHS region

The proportion who reported having implants varied from 3% in the Midlands to 8% in London.

Household income

The proportion of adults who said they had implants varied with income from 3% in the lowest income quintile to 7% in the highest income quintile.

Neighbourhood deprivation

The proportion of adults with dental implants varied with neighbourhood deprivation with no clear pattern.

The proportion of adults with dental implants was similar for men and women.

Condition of teeth

Introduction

Survey participants with natural teeth were asked whether any of their teeth, fillings, crowns or fixed bridges were painful to bite on and whether any of their teeth, fillings, crowns or fixed bridges were damaged, cracked or broken.

The survey took place in early 2021, a year after the pandemic had restricted access to dental care. An earlier report of the 2021 adult oral health survey discussed the impact of this on participants’ need for dental care and how this was met.

Pain

One in 10 (10%) adults with natural teeth reported that they had teeth, fillings, crowns or fixed bridges that were painful to bite on, including similar proportions of men and women.

Age

The prevalence of dental pain varied by age. The youngest and oldest adults were least likely to report dental pain (6% of those aged 16 to 24 years and 5% of those aged 75 years and over). Dental pain was most commonly reported by adults aged 35 to 44 years (13%). 

Figure 11: proportion of adults reporting any teeth, fillings, crowns or fixed bridges that are painful to bite on, by age

Base: all adults reporting having natural teeth.

Error bars show the 95% confidence interval around the estimates.

Source: Table 11 in the data tables.

NHS region

Adults living in the East of England were least likely to report that their teeth, fillings, crowns or fixed bridges were painful to bite on (7%). This proportion was highest among adults in the North West (13%).

Household income

The proportion of adults who reported that their teeth, fillings, crowns or fixed bridges were painful to bite on varied from 13% in the lowest income quintile to 6% in the highest income quintile.

Figure 12: proportion of adults reporting any teeth, fillings, crowns or fixed bridges that are painful to bite on, by household income

Base: all adults reporting having natural teeth.

Error bars show the 95% confidence interval around the estimates.

Source: Table 11 in the data tables.

Neighbourhood deprivation

The proportion of adults who reported that their teeth, fillings, crowns or fixed bridges were painful to bite on was highest in the most deprived quintile (15%) and between 7% and 10% in other quintiles.

Figure 13: proportion of adults reporting any teeth, fillings, crowns or fixed bridges that are painful to bite on, by neighbourhood deprivation

Base: all adults reporting having natural teeth.

Error bars show the 95% confidence interval around the estimates.

Source: Table 11 in the data tables.

The proportion of adults who reported that their teeth, fillings, crowns or fixed bridges were painful to bite was similar for men and women.

Damage to teeth, fillings, crowns or fixed bridges

A quarter (25%) of adults with natural teeth reported that they had teeth, fillings, crowns or fixed bridges that were damaged, cracked or broken.

Sex

Men (27%) were more likely than women (23%) to report that any of their teeth, fillings, crowns or fixed bridges were damaged, cracked or broken.

Age

The proportion of adults reporting damage to any of their teeth, fillings, crowns or fixed bridges varied with age. It was least common among those aged 16 to 24 years (10%). About 1 in 3 adults aged between 35 to 74 years reported such damage, ranging from 28% of those aged 35 to 44 years to 31% of those aged between 65 and 74 years.

Household income

Adults in the 2 lowest income quintiles were most likely to report any of their teeth, fillings, crowns or fixed bridges were damaged, cracked or broken (28%). This proportion was lower in higher income households: 21% in the second highest and 20% in the highest income quintile.

Neighbourhood deprivation

Adults in the 2 most deprived quintiles were more likely to report any of their teeth, fillings, crowns or fixed bridges were damaged, cracked or broken (29%) compared to those in 2 least deprived quintiles (22% in the second least deprived quintile and 21% in the least deprived quintile).

The proportion of adults reporting damage to any of their teeth, fillings, crowns or fixed bridges did not statistically differ across NHS regions.

Periodontal health

Introduction

Information about participants’ periodontal (gum) health was collected through self-completion questionnaires. Dentate participants were asked:

  • if they had ever been told by a dental health professional that they had gum disease
  • whether their gums bled when they ate some foods or when they cleaned their teeth
  • whether they had ever had any teeth become loose on their own, without an injury

Diagnosed gum disease

Almost a fifth (19%) of adults with natural teeth reported having been told they had gum disease by a dental health professional.

Sex

Just over a fifth (21%) of women reported having been told they had gum disease, compared with 17% of men.

Age

The proportion of adults reporting having been told they had gum disease increased from 4% of those aged 16 to 24 years to 28% of those aged 55 to 64 years.

Figure 14: proportion of adults reporting having been told they have gum disease, by age

Base: all adults reporting having natural teeth.

Error bars show the 95% confidence interval around the estimates.

Source: Table 13 in the data tables.

NHS region

The proportion of adults reporting having been told they had gum disease varied by NHS region, from 16% in the North East and Yorkshire to 24% in London.

Household income

The proportion of adults reporting having been told they had gum disease varied across income quintiles from 16% to 22%, with no clear pattern across quintiles.

The proportion of adults reporting having been told they had gum disease was similar across neighbourhood deprivation quintiles and did not vary significantly according to usual pattern of dental attendance.

Bleeding gums

Twenty-seven per cent of adults with natural teeth reported that their gums bled, including 25% whose gums bled when cleaning their teeth and 3% whose gums bled when eating some foods.

Age

Adults aged between 25 and 54 years were most likely to report bleeding gums, with prevalence varying between 31% and 33% across this age range. The proportion was lowest among the oldest age group (12% of adults aged 75 years and over).

NHS region

Adults living in the South West (22%) were least likely to report their gums bled. Those living in the North East and Yorkshire and the North West were most likely to report bleeding gums (30%).

Household income

The proportion of adults who reported bleeding gums varied with household income. It was lower in the 3 highest income quintiles (between 23% and 25%) and higher in the second lowest (29%) and lowest (33%) income quintiles.

Neighbourhood deprivation

The proportion of adults who reported that their gums bled varied with neighbourhood deprivation from 35% in the most deprived areas to 20% in the least deprived areas.

Figure 15: proportion who said their gums bled, by neighbourhood deprivation

Base: all adults reporting having natural teeth.

Error bars show the 95% confidence interval around the estimates.

Source: Table 13 in the data tables.

Usual pattern of dental attendance

Whether participants reported that their gums bled varied according to their usual pattern of dental attendance. Twenty-two per cent of adults who went for regular check-ups reported this, compared with 29% of those who went for occasional check-ups and 39% of those who either visited a dentist only when they had trouble or who said that they had never been to the dentist.

Loose teeth

Sixteen per cent of adults reported to have had a tooth not become loose, without an injury.

Sex

Men (18%) were more likely to report having had a tooth become loose, without an injury,  than women (14%).

Age

The percentage of adults having had a tooth become loose, without an injury, increased by age from 8% among those aged 16 to 24 years to 24% among those aged 75 years and older.

Household income

The proportion of adults who had ever had a tooth become loose, without an injury, varied with household income. The proportions were lowest in the 2 highest income quintiles (8% in the second highest and 12% in the highest income quintile) and highest in the lowest income quintile (20%).

Neighbourhood deprivation

The proportion of adults reporting ever having had a tooth become loose, without an injury, decreased with neighbourhood deprivation from 22% in the most deprived quintile to 11% in the 2 least deprived quintiles.

Usual pattern of dental attendance

Adults who went to the dentist for a regular check-up (13%) or an occasional check-up (10%) were less likely to have ever had a tooth become loose, without injury, than those who only went to the dentist when they had a problem or who said they never went (both 28%).

The proportion of adults who had ever had a tooth become loose, without an injury, was similar across NHS regions.

Dry mouth

Introduction

Dry mouth (xerostomia) occurs when the salivary glands do not produce enough saliva. Dry mouth may result from diseases such as diabetes and as a side effect of some medications. Having a dry mouth increases the risk of tooth decay and mouth infections.

All survey participants were asked how often their mouth felt dry:

  • 1% reported that their mouths always felt dry
  • 9% reported that their mouths frequently felt dry
  • 57% reported that their mouths occasionally felt dry
  • 33% reported that their mouths never felt dry

Sex

Women (12%) were more likely than men (8%) to report that their mouths always or frequently felt dry.

Age

The proportion of adults reporting that their mouths always or frequently felt dry increased with age from 5% of those aged 16 to 24 years to 16% of those aged 75 years and over.

Figure 16: proportion of adults whose mouth always or frequently felt dry, by age

Base: all adults.

Error bars show the 95% confidence interval around the estimates.

Source: Table 15 in the data tables.

NHS region

There were differences across regions in the proportions of participants whose mouths always or frequently felt dry, ranging from 6% in London to 12% in the North West.

Household income

Adults in the 2 lowest household income quintiles were more likely to report that their mouths always or frequently felt dry (12% in the lowest quintile and 14% in the second lowest quintile). This proportion was between 7% and 8% of adults in higher income quintiles.

Neighbourhood deprivation

Fifteen per cent of adults in the most deprived quintile reported that their mouths always or frequently felt dry, compared with between 8% and 10% in all other quintiles.

Usual pattern of dental attendance

Nine per cent of adults who went for regular check-ups and 10% of those who went for occasional check-ups reported that their mouths always or frequently felt dry. This was more frequently reported by those who only went to the dentist when they had trouble (12%) and those who said they had never been to the dentist (13%).



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