9: Adult Dental Health Survey 2009 Wales Key Findings

Transcription

1 UK Data Archive Study Number - Adult Dental Health Survey, : Adult Dental Health Survey 2009 Wales Key Findings Copyright 2011, The Health and Social Care Information Centre. All Rights Reserved. 1

2 The NHS Information Centre is England s central, authoritative source of health and social care information. Acting as a one-stop-shop for high quality, national, comparative data, we deliver information for local decision makers, to improve the quality and efficiency of care. Author: Victoria Chenery, Elizabeth Treasure Editor: Ian O Sullivan Responsible Statistician: Phil Cooke, Section Head, Dental and Eye Care Version: 1.0 Date of Publication: 24 th March Copyright 2011, The Health and Social Care Information Centre. All Rights Reserved.

3 Contents Introduction 4 1 Oral health and function 5 2 Disease and related disorders 6 3 Urgent conditions 7 4 Complexity and maintenance 7 5 Preventive behaviour and risks to oral health 9 6 Service considerations 10 7 Outcome and impact 12 8 Access and barriers to care 13 Tables 15 Copyright 2011, The Health and Social Care Information Centre. All Rights Reserved. 3

4 Introduction The 2009 Adult Dental Health Survey (ADHS) is the fifth in a series of national dental surveys that have been carried out every decade since The main purpose of these surveys has been to get a picture of the dental health of the adult population and how this has changed over time. The 2009 survey was commissioned by the NHS Information Centre for health and social care and was conducted on behalf of the Department of Health in England, the Welsh Assembly Health Department, and the Department of Health, Social Services and Public Safety in Northern Ireland. The survey was carried out in England, Wales, and Northern Ireland only: Scotland did not participate in the 2009 survey. Wales has participated in all of the ADH surveys since This report draws together the key clinical, behavioural and attitudinal dental estimates for Wales from the 2009 survey and also comments where possible on trends between 1978 and The overall sample size for the 2009 survey was 13,400 households, 1,150 were in Wales. Data collection for the survey took place between October 2009 and April 2010, and the final overall household interview response rate was 60 per cent. In Wales the household response rate was 63 per cent and a total of 998 individuals (including dentate and edentate adults) were interviewed. Of the dentate adults that were interviewed (n = 888) a total of 534 consented to the dental examination (consent rate 60 per cent) and 415 adults were actually examined (final examination conversion rate 47 per cent). The majority of Tables referenced in the subsections below can be viewed in the specific reports for the overall findings (for England, Wales and Northern Ireland). For example, in the section below on Function and Health the estimates for the rate of total tooth loss in Wales can be seen in Table in Oral health and function: a report from the Adult Dental Health Survey A compendium of additional tables are also presented in this report; while some estimates in these Tables will be presented herein, there will be no discussion of these data by the variables with which they are crosstabulated, including age, sex and socio-economic classification of the household. These additional tables are to be found at the back of the report. Full background and methodological details for the survey, can be found in Foundation report: Adult Dental Health Survey A glossary of all clinical terms can also be found in this report. 4 Copyright 2011, The Health and Social Care Information Centre. All Rights Reserved.

5 1 Oral health and function The proportion of adults who have retained some of their natural teeth is an important indicator of the oral health of a population. The majority of Tables referenced in the subsections below can be found in Oral health and function: a report from the Adult Dental Health Survey Natural Teeth In 2009, 90 per cent of all adults in Wales were dentate and 10 per cent were edentate. (Table and Table 1.1.1) Ninety-five per cent of dentate adults had natural teeth in both arches, 5 per cent had teeth in the lower arch only and fewer than 0.5 per cent have teeth in the upper arch only. (Table 1.1.3) Number of natural teeth The average number of natural teeth of dentate adults in Wales is The majority of dentate adults in Wales (51 per cent) had between 27 and 32 teeth. (Table and Table 1.2.1) Eighty per cent of dentate adults in Wales have 21 or more natural teeth. (Table 1.2.2) Dentate adults in Wales had an average of 16.3 sound and untreated teeth and 15.9 sound, untreated teeth and roots (Tables and 1.2.4) Forty-three per cent of dentate adults in Wales had 18 or more sound and untreated teeth and 41 per cent had 18 or more sound and untreated teeth and roots. (Tables and 1.2.6) Periodontally healthy sextants Thirteen per cent of dentate adults were classed as periodontally healthy (pocketing and loss of attachment less than 4mm) and had no calculus or bleeding; 29 per cent were periodontally healthy but had calculus and/or bleeding; and 57 per cent of dentate adults had loss of attachment and pocketing of 4mm or more. (Table 1.3.1) Excellent oral health Seven per cent of dentate adults had excellent oral health that is had 21 or more teeth, 18 or more sound and untreated teeth, no active decay at any site, no periodontal pocketing or loss of attachment above 4mm, and no plaque or calculus. (Table 1.4.1) Trends In 1978, 37 per cent of all adults in Wales were edentate, this fell to 22 per cent in 1988, 17 per cent in 1998 and 10 per cent in (Table 9.1.3) Eighty-two per cent of adults aged 75 and over were edentate in 1988, this fell to 64 per cent in In 2009, 42 per cent of adults aged 75 and over were edentate. (Table 9.1.3) In 1978, dentate adults in Wales had 22.4 teeth on average; this increased to 24.3 in (Table 9.1.4) Copyright 2011, The Health and Social Care Information Centre. All Rights Reserved. 5

6 In 1978, 27 per cent of dentate adults had 18 or more sound and untreated teeth, this increased to 43 per cent in (Table 9.1.5) On average dentate adults in Wales had 13.3 sound and untreated teeth in 1978; this increased to 16.3 in (Table 9.1.5) 2 Disease and related disorders The current distribution of obvious dental caries (decay), periodontal (gum) disease and tooth wear in Wales is presented along with some trends over time. The majority of Tables referenced in the subsections below can be found in Disease and related disorders: a report from the Adult Dental Health Survey Caries In Wales, 47 per cent of dentate adults had carious teeth (crowns and roots) in (Table 2.1.1) Dentate adults had a mean number of 1.1 carious teeth (crown and roots). (Table 2.1.3) Adults with at least one carious tooth had a mean number of 2.4 carious teeth. (Table 2.1.4) Forty-three per cent of dentate adults had primary or secondary caries. (Table 2.1.6) Amongst dentate adults 33 cent had primary caries. Of these adults 17 per cent had one tooth with primary decay; 8 per cent had two teeth with primary decay; and 7 per cent had three or more teeth with primary decay. (Tables and ) Thirteen per cent of dentate adults in Wales had secondary caries. Of these adults 9 per cent had one tooth with secondary decay, and 4 per cent had two or more teeth with secondary decay. (Tables and ) Ten per cent of dentate adults had roots with active decay. (Table ) Periodontal condition Fifty-six per cent of dentate adults had bleeding; 50 per cent had pocketing of 4mm or more; 8 per cent had pocketing of 6mm or more. (Table and Table 2.2.1) Seventy-seven per cent of dentate adults aged 55 years and over had loss of attachment (LOA) of 4mm or more; 33 per cent had LOA of 6mm or more; and 3 per cent had LOA of 9mm or more. (Table 2.2.5) Tooth wear Eighty-seven per cent of dentate adults had some wear in their anterior teeth; 18 per cent had some moderate wear; and 2 per cent had some severe wear on their anterior teeth. (Table 2.3.1) Trends In 1998, 47 per cent of dentate adults in Wales had periodontal pocketing of 4mm or more, this increased to 50 per cent in 2009; 4 per cent had periodontal pocketing of 6mm or more in 1998, this increased to 8 per cent in (Table 9.2.2) 6 Copyright 2011, The Health and Social Care Information Centre. All Rights Reserved.

7 Sixty-seven per cent of dentate adults had wear on their anterior teeth in 1998, compared with 87 per cent in 2009; 15 per cent of dentate adults had moderate wear on their anterior teeth in 1998 compared with 18 per cent in 2009; and less than half of one per cent of dentate adults had severe wear on their anterior teeth in 1998 compared with 2 per cent in (Table 9.2.3) 3 Urgent conditions Urgent conditions including dental pain, open dental pulps and oral sepsis, and untreated teeth with extensive decay, are an important and sometimes dominant factor in dental behaviour, and the prevalence and distribution of these conditions needs to be measured alongside estimates of the current state of adult dental health. The majority of Tables referenced in the subsections below can be found in Urgent conditions: a report from the Adult Dental Health Survey Pain Eight per cent of dentate adults in Wales reported feeling current pain related to their teeth. (Table 3.1.1) Seventy-six per cent of dentate adults reported never or hardly ever feeling dental pain in the previous 12 months; 16 per cent reported feeling dental pain occasionally and 8 per cent reported feeling dental pain fairly or very often. (Table 3.1.4) PUFA is a recently developed index of clinical consequences of untreated dental caries. It provides a measure of badly diseased and broken down teeth which have been attacked by dental decay and are causing significant problems in need of early attention. PUFA relates to open pulp, ulceration, fistula and abscess. Eight per cent of dentate adults had at least one PUFA symptom. Five per cent of dentate adults had open pulp, 2 per cent had ulceration and 2 per cent had a fistula or abscess. (Table 3.2.1) Condition of teeth Thirteen per cent of dentate adults had one or more teeth with unrestorable caries. (Table 3.3.1) Urgent conditions Overall, 75 per cent of dentate adults had no urgent conditions; 16 per cent of had one urgent problem; 6 per cent had two urgent conditions; 2 per cent had three urgent conditions; and less than 1 per cent had four urgent conditions. (Table 3.4.1) 4 Complexity and maintenance The estimates presented below focus on the oral health of people in Wales by measuring the extent of the accumulated effects of restorative treatment and where these effects fall in the population. The majority of Tables referenced in the subsections below can be found in Complexity and maintenance: a report from the Adult Dental Health Survey Copyright 2011, The Health and Social Care Information Centre. All Rights Reserved. 7

8 Fillings and Crowns Eighty-six per cent of dentate adults had one or more fillings (crown and root surfaces). (Table 4.1.1) Adults with at least one filling had 7.2 filled teeth and 15.7 filled surfaces on average. The ratio of filled surfaces per filled tooth was 2.0. (Table 4.1.2) Thirty-seven per cent of dentate adults in Wales had one or more crowns. (Table 4.1.5) Adults with crowns had 2.8 crowns on average. (Table 4.1.7) Restored teeth and surfaces In 2009, 87 per cent of dentate adults in Wales had one or more restored teeth. (Table 4.2.1) These adults had, on average, 8.6 restored teeth and 20.3 restored surfaces. (Table 4.2.2) Fifteen per cent of adults with one or more restored teeth had restorations with secondary decay; 32 per cent had unsound restorations. (Table 4.2.6) Denture use Overall, in per cent of all adults had natural teeth only; 15 per cent had natural teeth and dentures; 10 per cent were edentate with dentures; and less than 0.5 per cent were edentate with no dentures. (Table 4.4.1) Eighty-five per cent of dentate adults had natural teeth only; 8 per cent had a partial denture in one arch; 2 per cent had partial dentures in both arches; 2 per cent had a complete denture in one arch and a partial denture in the other arch; and 3 per cent had a complete denture in one arch only. (Table 4.4.2) Six per cent of dentate adults had at least one dental bridge. (Table 4.4.3) Less than one half of one per cent of dentate adults had at least one dental implant. (Table 4.4.5) Complexity In order to establish the complexity of dental treatment required eight indicators have been identified reflecting previous treatment or current disease. Four of the criteria are related to disease, three to existing restorative treatment load and one to reported problems impacting on daily life. During the oral examination each ADHS respondent was given a score based on these indicators. Individually none of these may present a particular clinical challenge, but in combination they may. In 2009, 30 per cent of dentate adults had a complexity score of zero; 26 per cent had a complexity score of one; 21 per cent had a complexity score of two; 13 per cent had a complexity score of three; 6 per cent had a complexity score of four; and 4 per cent had a complexity score of five or more. (Table 4.5.3) Trends In 1978, dentate adults in Wales had 7.3 restored and otherwise sound teeth on average; this increased to 7.7 in Utilising the revised 1998 criteria the average 8 Copyright 2011, The Health and Social Care Information Centre. All Rights Reserved.

9 number of restored but otherwise sound teeth in 1998 was 7.9 in 2009 this had decreased to 6.7 teeth. (Table 9.4.1) In 1978, the average number of restored but otherwise sound teeth for adults aged 16 to 24 was 7.2 teeth (1988 criteria) compared with 1.9 in 2009 (1998 criteria). (Table 9.4.1) 5 Preventive behaviour and risks to oral health Good oral hygiene helps prevent dental problems such as the accumulation of plaque and calculus, which contribute to the development of gum disease and tooth decay. Daily preventive care including brushing is essential and will help stop dental problems before they develop. The majority of Tables referenced in the subsections below can be found in Preventive behaviour and risks to oral health: a report from the Adult Dental Health Survey Oral hygiene Seventy-one per cent of dentate adults said that they cleaned their teeth twice a day or more often and 25 per cent said that they did once a day. Three per cent of dentate adults said that they cleaned their teeth less than once a day and 1 per cent said they never cleaned their teeth. (Table and Table 5.1.1) Seventy-six per cent of dentate adults in Wales used toothpaste with a fluoride content of ppm, 17 per cent used toothpaste with a fluoride content of ppm and 6 per cent used toothpaste with a fluoride content of 550ppm or less. (Table 5.1.3) Fifty-four per cent of dentate adults in Wales use a toothbrush and toothpaste and 46 per cent use other dental products. Twenty-five per cent of dentate adults reported using mouthwash, 19 per cent reported using an electric toothbrush and 16 per cent reported using dental floss. (Table 5.1.5) Overall, 74 per cent of dentate adults reported that they had been given advice on brushing their teeth from a member of a dental team. (Table 5.1.7) Risks to dental health In 2009, 24 per cent of all adults in Wales indicated that they smoke. Twenty-three per cent of dentate adults said that they were current smokers. (Tables and 9.5.3, and Tables and 5.2.2) Over half of dentate adults in Wales (51 per cent) were classified as having a high sugar intake that is they consume cakes, puddings, biscuits, pastries, sweets, chocolate or fizzy drinks six times a week or more. (Table and Table 5.2.4) Visible plaque Seventy-seven per cent of dentate adults in Wales had visible plaque. The average number of teeth with visible plaque amongst dentate adults in was 7.7, and the average percentage of teeth with visible plaque was 32 per cent. (Table and Table 5.2.7) Sixty-seven per cent of dentate adults in Wales had calculus and the average number of sextants with calculus was 1.5. (Table and Table ) Copyright 2011, The Health and Social Care Information Centre. All Rights Reserved. 9

10 Trends In 1988, 64 per cent of dentate adults in Wales said that they cleaned their teeth at least twice a day, this rose to 74 per cent in 1998 but fell to 71 per cent in In 1988, 27 per cent of dentate adults said that they cleaned their teeth once a day; this fell to 21 per cent in 1998 but rose to 25 per cent in (Table 9.5.6) In 1978, 85 per cent of dentate adults in Wales used just an ordinary toothbrush and toothpaste to care for their teeth; this fell to 71 per cent in 1988; and to 48 per cent in 1998; it rose to 54 per cent in Mouthwash was used by 9 per cent of dentate adults in 1988, this rose to 24 per cent in 1998, and to 25 per cent in The use of dental floss increased from 6 per cent in 1978; to 14 per cent in 1988; and to 25 in However it fell to 16 per cent in (Table 9.5.7) Fifty-nine per cent of dentate adults reported receiving dental hygiene advice from a member of a dental team in 1998; in 2009 this had increased to 74per cent. (Table 9.5.8) In 1998, 52 per cent of dentate adults in Wales had visible plaque compared with 77 per cent in The mean number of teeth with visible plaque has increased from 4.3 in 1998 to 7.7 in (Table 9.5.9) The average percentage of teeth with visible plaque in 1998 was 18 per cent compared with 32 per cent in (Table 9.5.9) 6 Service considerations This estimates presented below illustrate adults in Wales use of and interactions with all types of dental health services. The majority of Tables referenced in the subsections below can be found in Service considerations: a report from the Adult Dental Health Survey Dental attendance Sixty-nine per cent of dentate adults in Wales reported attending the dentist for regular check-ups; 7 per cent reported attending occasionally; 23 per cent reported attending only when they had trouble with their teeth. One per cent of adults said that they had never attended the dentist. (Table and Table 6.1.1) Fifty-nine per cent of dentate adults reported attending the dentist at least every six months; 17 per cent said that they attended every year; 3 per cent said that they went every two years, 7 per cent reported attending less frequently than this; and 14 per cent reported only attending when they had trouble with their teeth. (Table 6.1.4) Overall, 79 per cent of dentate adults in Wales indicated that they attended the dentist at least every two years. (Table 6.1.5) Sixty per cent of dentate adults reported their current dental attendance was about the same as it was five years ago; 14 per cent reported they went more often; and 25 per cent reported they attended less often than they did five years ago. (Table 6.1.6) Sixty per cent of dentate adults reported their last dental visit was six months prior to the survey interview; 16 per cent visited seven to twelve months prior to interview; and 9 per cent between 12 months and two years prior to interview. Overall 85 per cent of dentate adults reported they last visited their dentist within the previous two years. (Tables and 6.1.8) 10 Copyright 2011, The Health and Social Care Information Centre. All Rights Reserved.

11 Dental service Twenty-nine per cent of dentate adults received private dental care at their last completed course of dental treatment; 37 per cent paid for NHS care; and 33 per cent received free NHS dental care. Overall 70 per cent of dentate adults received either paid for or free NHS dental care. (Table 6.2.1) Forty-four per cent of dentate adults in Wales paid nothing towards the cost of their last course of dental treatment; 22 per cent paid between 1 and 20; 20 per cent paid between 21 and 50; 6 per cent between 51 and 100; 5 per cent paid between 101 and 200; 2 per cent paid between 201 and 500; and 1 per cent paid over 501 pounds. (Table 6.2.2) Eighteen per cent of dentate adults indicated that they had a dental insurance plan. (Table 6.2.3) Dentate adults who had NHS treatment at their last course of completed treatment were asked why they chose NHS treatment. Sixty-three per cent of dentate adults cited affordability; 23 per cent cited location of the practice; 14 per cent reported it was because of the reputation of the dentist; and 14 per cent reported that their dentist only sees NHS patients. (Table 6.2.4) Dentate adults who had private dental care during their last course of dental treatment were asked why they chose private care. Fifty-three per cent of adults said they used private dental care because their NHS dentist had gone private; 40 per cent said they were unable to find an NHS dentist; 10 per cent cited better quality of care and 10 per cent cited better reputation of the practice. (Table 6.2.5) Dentate adults that had private dental care during their last course of dental treatment were asked what would encourage them to use the NHS. Fifty-four per cent said having an NHS dentist in their area would encourage them to access the NHS; 20 per cent said nothing would encourage them to use the NHS; and 11 per cent said they would access NHS dental care if it was in a more convenient location. (Table 6.2.6) Thirty-two per cent of dentate adults in Wales said that they did not attend the dentist in the last two years because they couldn t find an NHS dentist; 27 per cent of them felt there was nothing wrong with their teeth and so they had no need to go. Being afraid to go to the dentist and not seeing the point in going was given as a reason for non-attendance by 26 per cent of dentate adults. Twenty per cent of dentate adults said they had not been to the dentist in the last two years because of a previous bad experience. (Table 6.2.7) Treatment Seventy-three per cent of dentate adults in Wales completed their last course of treatment in one visit; 27 per cent of adults that needed more than one visit. (Table 6.3.1) Eighty-eight per cent of dentate adults in Wales had a check-up at their last course of treatment; 46 per cent had their teeth scaled and polished; 27 per cent had a tooth filled; and 28 per cent had an X-ray. Thirty-five per cent of dentate adults received advice on looking after their teeth during their last course of treatment. (Table 6.3.4) Seventy-four per cent of dentate adults in Wales rated their last completed course of treatment as good or very good value for money; 16 per cent of adults rated the cost of their last course of dental treatment as fair; and 9 per cent rated it as poor or very poor value for money. (Table 6.3.6) Ninety per cent of adults in Wales reported having a filling during the course of their lifetime; 80 per cent have had a tooth extracted (other than their wisdom teeth); 77 per Copyright 2011, The Health and Social Care Information Centre. All Rights Reserved. 11

12 cent have received a scale; and polish and 44 per cent have had a wisdom tooth extracted. (Table ) Dental practice Ninety-one per cent of adults in Wales had visited the dental practice before their most recent visit; for 9 per cent of adults their most recent visit to their dental practice had been their first one to that practice. (Table 6.4.1) Sixty-nine per cent of adults in Wales have been attending the dental practice they had attended at their last visit for five or more years; 21 per cent had been attending for the last two to four years; 6 per cent had been attending for at least a year but less than two years; and 3 per cent had been attending this practice for at least a year. (Table 6.4.2) Trends In 1978, 39 per cent of dentate adults in Wales reported that they attended the dentists for regular check up; this had risen to 48 per cent in 1988; to 59 per cent in 1998 and to 69 per cent in (Table 9.6.2) Fifty-two per cent of dentate adults in 1998 received a scale and polish during their last course of treatment compared with 46 per cent in 2009; 26 per cent of adults had a tooth filled in 1998 compared with 27 per cent in (Table 9.6.3) 7 Outcome and impact The subjective perceptions of respondents in relation to their general health, oral health and quality of life are important factors to understand, especially as they give a non-clinical indication of the potential demand for dental services and treatment. The majority of Tables referenced in the subsections below can be found in Outcome and impact: a report from the Adult Dental Health Survey Self-rated general and dental health Eighty-two per cent of dentate adults in Wales reported that they had good/very good general health and 73 per cent rated their dental health as being good/very good. (Table 7.1.2) Oral Health Impact Profile (OHIP-14) Twenty-four per cent of dentate adults reported experiencing physical pain occasionally or more often as a result of oral health conditions; 17 per cent experienced psychological discomfort. Thirty-two per cent of dentate adults reported experiencing at least one problem concerning their oral health. (Table 7.2.6) Oral Impact on Daily Performance (OIDP) Twenty-seven per cent of all dentate adults in Wales reported having difficulty with at least one item on the OIDP scale. Eighteen per cent of all dentate adults reported a degree of difficulty with eating because of oral health problems and 13 per cent reported difficulties when smiling or showing their teeth. (Table ) 12 Copyright 2011, The Health and Social Care Information Centre. All Rights Reserved.

13 The vast majority (73 per cent) of dentate adults in Wales had no oral impacts as measured by the OIDP scale however, the average score was 3.9. Eight per cent reported one problem; 7 per cent reported two problems; 5 per cent reported three problems; 4 per cent reported four problems; and four per cent five problems. (Table ) Of those dentate adults that reported a problem that impacted on their daily performance 30 per cent reported one problem; 25 per cent reported two problems; 18 per cent reported three problems; 13 per cent reported four problems; and 14 per cent reported five problems. The mean total score OIDP score was (Table ) Trends Fifty-one per cent of dentate adults reported no problems on the OHIP scale in 1998, compared with 68 per cent in (Table 9.7.1) In 2009, a almost a quarter (24 per cent) of dentate adults reported feeling physical pain occasionally or more often in the previous 12 months, this has fallen from 36 per cent in Twenty-five per cent of dentate adults in 1998 reported feeling psychological discomfort compared with 17 per cent in (Table 9.7.2) 8 Access and barriers to care The estimates below illustrate the experience of adults in Wales in accessing NHS dental care and explores some of the barriers to access. In addition estimates of the levels of anxiety among adults in Wales who have ever been to a dentist, are also presented. The majority of Tables referenced in the subsections below can be found in Access and barriers to care: a report from the Adult Dental Health Survey Access to care Fifty-seven per cent of all adults in Wales had tried to make an NHS appointment in the last three years. (Table 8.1.1) Of those who had tried to make an NHS appointment in the previous three years, 91 per cent were successful and attended this appointment; a further 2 per cent successfully made an appointment but did not attend. Seven per cent were unable to make an appointment. (Table 8.1.4) Eighty-eight per cent of adults in Wales who tried successfully made an NHS appointment for themselves in the previous three years already had an NHS dentist when they tried to make this appointment. Ten per cent of adults were able to make an appointment with the first NHS dentist they tried; a small minority (3 per cent) had to make at least two (but in some cases more than five) visits or phone calls before they obtained an appointment. (Table 8.1.7) Cost Seventy-eight per cent of adults in Wales said their treatment they had received in the past was not affected by costs and 84 per cent said their treatment was not delayed because of costs. Eighty-six per cent of adults reported that their dental treatment was neither affected nor delayed by cost. (Table and Table 8.2.1) Copyright 2011, The Health and Social Care Information Centre. All Rights Reserved. 13

14 Modified Dental Anxiety Scale (MDAS) Fifty-five per cent of all adults in Wales would not feel anxious if going for dental treatment tomorrow; 34 per cent would feel slightly/fairly anxious; and 11 per cent would feel very/extremely anxious. (Table and Table 8.3.1a) Fifty-one per cent of adults would not feel anxious when in the dentists waiting room; 35 per cent would feel slightly/fairly anxious; and 14 per cent would feel very/extremely anxious. (Table and Table 8.3.1a) Thirty-three per cent of adults would not feel anxious if they were about to have a tooth drilled; 41 per cent would feel slightly/fairly anxious; and 26 per cent would feel very/extremely anxious. (Table and Table 8.3.1a) Sixty-three per cent of adults would not feel anxious if they were about to have a scale and polish; 29 per cent would feel slightly/fairly anxious; and 8 per cent would feel very/extremely anxious. (Table and Table 8.3.1b) Thirty-five per cent of adults would not feel anxiety if they were about to have an injection; 40 per cent would feel slightly/fairly anxious; and 25 per cent would feel very/extremely anxious. (Table and Table 8.3.1b) Fifty-four per cent of adults had a total MDAS score of between five and nine (indicating low/no dental anxiety); 35 per cent had an MDAS score of between ten and eighteen (indicating moderate anxiety); and 11 per cent of adults had an MDAS score of 19 or more (indicating extreme dental anxiety). (Table and Table 8.3.1b) Relationship with dentist Ninety-two per cent of adults in Wales felt that their dentist listened carefully to them; 91 per cent of adults felt they were given enough time to discuss their oral health needs; 90 per cent felt they were involved as much as they wanted to be in decisions about their dental treatment; and 95 per cent indicated that they received answers from their dentists that they could understand. (Table 8.4.1a) Ninety-three per cent felt their dentist explained the reasons for their dental treatment in a way that could be understood; 97 per cent of adults felt their dentist treated them with dignity and respect; and 94 per cent had confidence and trust in their dentist. (Table 8.4.1b) Overall 84 per cent of adults gave no negative responses when questioned about their relationship with their dentist however, 16 per cent gave at least one negative response. (Table 8.4.1b) 14 Copyright 2011, The Health and Social Care Information Centre. All Rights Reserved.

15 Tables Presentation of data o o o o o Figures are rounded to the nearest whole value. This could have an impact on row or column percentages which may add to 99 per cent or 101 per cent. Where 0 per cent is shown in a table, this indicates that fewer than 0.5 per cent of people gave this answer. Instances where no answers for a particular response were given are indicated in the tables by '-'. A few respondents did not answer some questions. These no answers have been excluded from the analysis. Tables that describe the same population have slightly varying bases. The individual figures for unweighted sample sizes are rounded to the nearest 10 cases and may not add up to the figures shown in the totals. Small bases are associated with relatively high sampling errors and this affects the reliability of estimates. In general, percentage distribution is shown if the base is 30 or more. Where estimates are considered unreliable due to relatively high sampling error, figures in the tables are presented with a turquoise shaded background. Copyright 2011, The Health and Social Care Information Centre. All Rights Reserved. 15

16 Table Dental status by characteristics of adults All adults Wales: 2009 Characteristics of adults Dental status Unweighted Weighted Base Dentate Edentate Base (000s) All % ,000 2,437 Age % % % % % % and over % Sex Male % ,174 Female % ,263 Socio-economic classification of household 1 Managerial and professional occupations % Intermediate occupations % Routine and manual occupations % Excludes people in households where the household reference person was not interviewed. Respondents whose head of household/ household reference person was a full time student, in the Armed Forces, had an inadequately described occupation, had never worked or were long-term unemployed are not shown as separate categories but are included in the total. 16 Copyright 2011, The Health and Social Care Information Centre. All Rights Reserved.

17 Table Number of natural teeth by characteristics of dentate adults Dentate adults Wales: 2009 Characteristics of dentate adults Number of natural teeth Unweighted Weighted Base Mean Base (000s) All % ,204 Age % % % % % % and over % Sex Male % ,090 Female % ,113 Socio-economic classification of household 1 Managerial and professional occupations % Intermediate occupations % Routine and manual occupations % Excludes people in households where the household reference person was not interviewed. Respondents whose head of household/ household reference person was a full time student, in the Armed Forces, had an inadequately described occupation, had never worked or were long-term unemployed are not shown as separate categories but are included in the total. Shaded figures indicate the estimates are unreliable and any analysis using these figures may be invalid. Any use of these shaded figures must be accompanied by this disclaimer. Table Proportion of edentate adults: All adults Wales: Edentate Percentage All Age and over Sex Men Women Unweighted base ,000 Weighted base (000s) 2, Copyright 2011, The Health and Social Care Information Centre. All Rights Reserved. 17

18 Table Number of natural teeth by age: Dentate adults Wales: Mean number of teeth All Age and over Unweighted base Weighted base (000s) 2204 Table Number of sound untreated teeth by age: Dentate adults Wales: Percentage with 18 or more sound untreated teeth Mean number of sound untreated teeth 1978* 1988* 1998* 2009** 2009** # 1978* 1988* 1998* 2009** 2009**# All Age and over Unweighted base Weighted base (000s) 2,204 2, not shown with 1998 criteria as age breakdowns are not comparable. *1988 criteria **1998 criteria # age-adjusted 18 Copyright 2011, The Health and Social Care Information Centre. All Rights Reserved.

19 Table Presence of bleeding and periodontal pocketing by characteristics of dentate adults Dentate adults Wales: 2009 Characteristics of dentate adults Has bleeding Has periodontal pocket Has periodontal pocket Has periodontal pocket Unweighted Weighted depth of 4mm or more depth of 6mm or more depth of 9mm or more Base Base (000s) Yes No Yes No Yes No Yes No All % ,197 Age % % % % % % and over % Sex Male % ,090 Female % ,107 Socio-economic classification of household 1 Managerial and professional occupations % Intermediate occupations % Routine and manual occupations % Excludes people in households where the household reference person was not interviewed. Respondents whose head of household/ household reference person was a full time student, in the Armed Forces, had an inadequately described occupation, had never worked or were long-term unemployed are not shown as separate categories but are included in the total. Shaded figures indicate the estimates are unreliable and any analysis using these figures may be invalid. Any use of these shaded figures must be accompanied by this disclaimer. Copyright 2011, The Health and Social Care Information Centre. All Rights Reserved. 19

20 Table Periodontal condition by age: Dentate adults Wales: Periodontal pocketing Percentage with 4mm or more mm or more 4 8 9mm or more 1 2 Unweighted base Weighted base (000s) 2,197 1 Data not available for Table Any moderate or severe tooth wear in anterior teeth: Dentate adults Wales: Tooth wear Percentage with Any wear Some moderate wear Some severe wear 0 2 Unweighted base Weighted base (000s) 2,196 Table Mean number of restored, otherwise sound teeth by age: Dentate adults Wales: Mean number of restored otherwise sound teeth 1988 criteria 1998 criteria (adjusted)* 2009 (unadjusted) All Age and over Unweighted base Weighted base (000s) 2,204 2,204 *age groups adjusted 20 Copyright 2011, The Health and Social Care Information Centre. All Rights Reserved.

21 Table Dental hygiene in Wales by characteristics of dentate adults Dentate adults Wales: 2009 Characteristics of dentate adults Frequency of brushing teeth Unweighted Weighted Twice a day Once a day Less than Never Base Base (000s) or more once a day All % ,183 Age % % % % % % and over % Sex Male % ,060 Female % ,123 Socio-economic classification of household 1 Managerial and professional occupations % Intermediate occupations % Routine and manual occupations % Excludes people in households where the household reference person was not interviewed. Respondents whose head of household/ household reference person was a full time student, in the Armed Forces, had an inadequately described occupation, had never worked or were long-term unemployed are not shown as separate categories but are included in the total. Shaded figures indicate the estimates are unreliable and any analysis using these figures may be invalid. Any use of these shaded figures must be accompanied by this disclaimer. Copyright 2011, The Health and Social Care Information Centre. All Rights Reserved. 21

22 Table Smoking status in Wales by characteristics of adults All adults Wales: 2009 Characteristics of adults Percentage Unweighted Weighted who smoke Base Base (000s) All 24 1,000 2,437 Age and over Sex Men ,174 Women ,263 Socio-economic classification of household 1 Managerial and professional occupations Intermediate occupations Routine and manual occupations Excludes people in households where the household reference person was not interviewed. Respondents whose head of household/ household reference person was a full time student, in the Armed Forces, had an inadequately described occupation, had never worked or were longterm unemployed are not shown as separate categories but are included in the total. Shaded figures indicate the estimates are unreliable and any analysis using these figures may be invalid. Any use of these shaded figures must be accompanied by this disclaimer. 22 Copyright 2011, The Health and Social Care Information Centre. All Rights Reserved.

23 Table Smoking status in Wales by characteristics of dentate adults Dentate adults Wales: 2009 Characteristics of dentate adults Percentage Unweighted Weighted who smoke Base Base (000s) All ,201 Age and over Sex Men ,073 Women ,128 Socio-economic classification of household 1 Managerial and professional occupations Intermediate occupations Routine and manual occupations Excludes people in households where the household reference person was not interviewed. Respondents whose head of household/ household reference person was a full time student, in the Armed Forces, had an inadequately described occupation, had never worked or were longterm unemployed are not shown as separate categories but are included in the total. Shaded figures indicate the estimates are unreliable and any analysis using these figures may be invalid. Any use of these shaded figures must be accompanied by this disclaimer. Copyright 2011, The Health and Social Care Information Centre. All Rights Reserved. 23

24 Table Indicator of sugar intake in Wales by characteristics of dentate adults Dentate adults Wales: 2009 Characteristics of dentate adults Percentage of Unweighted Weighted adults with high Base Base (000s) sugar intake 1 All ,201 Age and over Sex Men ,073 Women ,128 Socio-economic classification of household 2 Managerial and professional occupations Intermediate occupations Routine and manual occupations Has cakes, biscuits, puddings or pastries, sweets or chocolate or fizzy drinks 6 or more times a week. 2 Excludes people in households where the household reference person was not interviewed. Respondents whose head of household/ household reference person was a full time student, in the Armed Forces, had an inadequately described occupation, had never worked or were long-term unemployed are not shown as separate categories but are included in the total. Shaded figures indicate the estimates are unreliable and any analysis using these figures may be invalid. Any use of these shaded figures must be accompanied by this disclaimer. 24 Copyright 2011, The Health and Social Care Information Centre. All Rights Reserved.

25 Table Presence of plaque and calculus by characteristics of dentate adults Dentate adults Wales: 2009 Characteristics of dentate adults Has visible plaque Has calculus Unweighted Weighted Yes No Yes No Base Base (000s) All % ,204 Age % % % % % % and over % Sex Male % ,090 Female % ,113 Socio-economic classification of household 1 Managerial and professional occupations % Intermediate occupations % Routine and manual occupations % Excludes people in households where the household reference person was not interviewed. Respondents whose head of household/ household reference person was a full time student, in the Armed Forces, had an inadequately described occupation, had never worked or were long-term unemployed are not shown as separate categories but are included in the total. Shaded figures indicate the estimates are unreliable and any analysis using these figures may be invalid. Any use of these shaded figures must be accompanied by this disclaimer. Copyright 2011, The Health and Social Care Information Centre. All Rights Reserved. 25

26 Table Reported frequency of tooth cleaning: Dentate adults Wales: Reported frequency of tooth cleaning % % % Twice a day or more often Once a day Less than once a day Never Unweighted Base Weighted Base (000s) 2,183 Figures for 1978 not shown as the survey categories were different. Table The use of dental hygiene products: Dentate adults 1 Wales: Dental hygiene product used Percentage who used: Just ordinary toothbrush & toothpaste Other products Mouthwash 2 NA Dental floss Interdens toothpick/woodstick Unweighted Base Weighted Base (000s) 2,171 Percentages may add to more than 100% as respondents could give more than one answer. 1 Excludes those who reported that they never cleaned their teeth. 2 Data not available for Table Dental hygiene advice: Dentate adults Wales: Percentage given dental hygiene advice/information 1 Unweighted Base Weighted Base (000s) 2,172 1 See main ADH report for question wording differences between 1998 and Copyright 2011, The Health and Social Care Information Centre. All Rights Reserved.

27 Table Visible plaque: Dentate adults Wales: Percentage of dentate adults with visible plaque Mean number of teeth with visible plaque Mean percentage of teeth with visible plaque Mean number of teeth Unweighted Base Weighted Base (000s) 2,204 Table Reasons for dental attendance in Wales by characteristics of dentate adults Dentate adults Wales: 2009 Characteristics of dentate adults Usual reason for dental attendance Unweighted Weighted Regular checkup Occasional Only when Never been to Base Base (000s) check-up having trouble the dentist All % ,201 Age % % % % % % and over % Sex Male % ,073 Female % ,128 Socio-economic classification of household 1 Managerial and professional occupations % Intermediate occupations % Routine and manual occupations % Excludes people in households where the household reference person was not interviewed. Respondents whose head of household/ household reference person was a full time student, in the Armed Forces, had an inadequately described occupation, had never worked or were long-term unemployed are not shown as separate categories but are included in the total. Shaded figures indicate the estimates are unreliable and any analysis using these figures may be invalid. Any use of these shaded figures must be accompanied by this disclaimer. Copyright 2011, The Health and Social Care Information Centre. All Rights Reserved. 27

28 Table Regular dental attendance: Dentate adults Wales: Country Percentage Regular attendance Unweighted Base Weighted Base (000s) 2,201 Table Treatment received at the last visit to the dentist: Dentate adults 1 Wales: Teeth scaled and polished Teeth filled X-ray Teeth extracted Crown fitted 6 5 Abscess treated 4 6 Denture fitted 5 3 Denture repaired 3 1 Unweighted Base Weighted Base (000s) 2,134 1 Excludes those who reported never attending the dentist. 2 Only includes those who were not in the middle of a course of treatment. 3 All respondents asked about treatment received during their last completed course of treatment. Percentages may add up to more than 100% as respondents could give more than one answer. 28 Copyright 2011, The Health and Social Care Information Centre. All Rights Reserved.

29 Table The number of reported problems based on OHIP-14 experienced at least occasionally in the preceding 12 months: Dentate adults Wales: Number of problems reported None At least At least At least Unweighted Base Weighted base (000s) 2,196 Copyright 2011, The Health and Social Care Information Centre. All Rights Reserved. 29

30 Table The impact of oral conditions in the preceding 12 months based on the frequency and type of reported problems: Dentate adults Wales: Type of problem Functional limitation Occasionally or more often 10 6 Occasionally 7 4 Fairly often 2 1 Very often 1 1 Physical pain Occasionally or more often Occasionally Fairly often 5 5 Very often 4 3 Psychological discomfort Occasionally or more often Occasionally 18 8 Fairly often 4 4 Very often 4 5 Physical disability Occasionally or more often 8 7 Occasionally 6 3 Fairly often 1 3 Very often 1 1 Psychological disability Occasionally or more often Occasionally 12 9 Fairly often 2 3 Very often 2 2 Social disability Occasionally or more often 5 5 Occasionally 4 4 Fairly often 1 1 Very often 1 1 Handicap Occasionally or more often 6 5 Occasionally 5 3 Fairly often 1 1 Very often 1 1 At least one problem Mean number of problems Mean total OHIP score Unweighted Base Weighted base (000s) 2,196 The statements and their groupings are derived from the Oral Health Impact Profile (OHIP-14) The same base is used for all percentages. 30 Copyright 2011, The Health and Social Care Information Centre. All Rights Reserved.