The Scottish Health Survey 2022 – volume 1: main report
This report presents results for the Scottish Health Survey 2022, providing information on the health and factors relating to health of people living in Scotland.
This document is part of a collection
4 Dental Health
In 2022, the majority of adults in Scotland had at least some natural teeth.
- 94% had some natural teeth
- 6% had no natural teeth
The two most common problems reported with mouth, teeth and dentures were:
- Difficulty in eating food: 6%
- And/or difficulty smiling, laughing and showing teeth without embarrassment: 6%
Mental wellbeing
In 2022, adults who had any issues with their mouth, teeth or dentures reported lower mental wellbeing on average than those who had no such issues. With mean WEMWBS scores of:
- 41.9 among those who reported such dental issues
- 47.7 who did not report any issues
WEMWBS scores range from 14 to 70. Higher scores indicate greater wellbeing.
Olga Martini
4.1 Introduction
In most industrialised countries the vast majority of adults have tooth decay[87]. The most common types of oral disease are tooth decay and gum disease. As tooth decay is widespread and is largely preventable, it is considered a public health issue. It is now widely recognised that a healthy mouth has a significant impact on physical health as well as on other aspects of day-to-day life including engaging with others socially and as a result, may have wider socio-economic consequences[88]. Access to oral health provision was negatively impacted by the Covid-19 pandemic, including a disproportionate impact on groups already predisposed to poorer oral health such as deprived communities and those with chronic conditions/comorbidities[89].
Oral health can both affect and be affected by mental health. For example, mental health issues can lead to neglect of oral hygiene, avoidance of dental visits, overbrushing and/or issues caused by medication[90], while oral health issues can result in physical pain, social isolation/withdrawal and/or an overall reduction in quality of life that have the potential to impact on an individual’s mental wellbeing3.
Oral cancer is the oral condition of greatest concern due to its seriousness and increasing incidence[91], particularly in Scotland when compared with the rest of the UK. Head and neck cancer, including oral and oropharyngeal cancers, is the eighth most common cancer in the UK, accounting for around 3% of total cases of cancer [92]. Major risk factors for oral cancer include tobacco use, excessive alcohol consumption, physical inactivity, with incidence higher among men, older age groups and those who are socioeconomically disadvantaged[93].
4.1.1 Policy background
The NHS Recovery Plan 2021-2026 invests targeted funding to increase NHS capacity, deliver reform, and ensure everyone has the treatment they need at the right time, in the right place, and as quickly as possible in aid of recovery from the Covid-19 pandemic[94]. These commitments were founded on the general objectives set out in the 2018 Oral Health Improvement Plan (OHIP)[95], which recognised the link between oral health and other public health issues, such as poor diet, smoking, alcohol consumption, inequalities and an ageing population.
It also set out strategies to transition from restorative to more preventative dentistry, with recognition of the impact that poor oral health can have on overall quality of life, health behaviours and health status.
The Oral Health Improvement Plan aims to ensure that good habits are learned during childhood and maintained into adulthood. In anticipation of 25% growth in the number of people aged over 75 during the next ten years[96], and the larger numbers of adults retaining some or all of their natural teeth, the OHIP also aims to provide a greater system of care for those in care homes and to people who receive care in their own homes[97].
As part of the commitment to improving people’s health and wellbeing, the Scottish Government runs various oral health improvement programmes, including the Childsmile programme (since 2006)[98]. This supports a range of measures aimed at children both in dental practices and in schools, nurseries and the community. Since Childsmile’s inception, the oral health of children in Scotland has improved markedly. For example, for P7 children, those showing no obvious signs of decay has increased from 53% to 80%[99].
4.1.2 Reporting on dental health in the Scottish Health Survey
This chapter updates data by age and sex on the number of natural teeth and on issues with mouth, teeth or dentures. Also reported are age-standardised mean WEMWBS scores by issues with mouth, teeth or dentures and sex. For a detailed description of age-standardisation as well as definitions of other terminology used in this chapter and further details on the data collection methods for dental health, please refer to Chapter 2 of the Scottish Health Survey 2022 - volume 2: technical report.
Supplementary tables on dental health are also published on the Scottish Government website: Scottish Health Survey.
4.2 Dental health
4.2.1 Number of natural teeth/no natural teeth (adults), 2022, by age and sex
In 2022, the majority (94%) of adults in Scotland had at least some natural teeth whilst 6% had none. Just over three quarters of adults (77%) had 20 or more natural teeth.
The association between natural teeth prevalence and age in 2022 continues the pattern documented in previous SHeS reports. In 2022, almost all adults (97-100%) aged 16-54 had at least some natural teeth, this proportion decreased with age to 76% among those aged 75 and over.
No significant differences were observed between men and women in natural teeth prevalence with the age groups following similar patterns for both sexes.
4.2.2 Issues with mouth, teeth or dentures, 2022, by age and sex
In 2022, most adults (89%) in Scotland reported having no issues with their mouth, teeth or dentures whilst the remaining 11% reported having one or more issues.
The two most common problems reported with mouth, teeth and dentures were difficulty in eating food (6%), and/or difficulty smiling, laughing and showing teeth without embarrassment (6%). The third most common (2%) problem was speaking clearly.
Overall, significant variations in issues with the mouth, teeth or dentures were not evident by age or sex. However, issues with eating food increased in prevalence with age, from 3% among those aged 16-34 to 10% among those aged 75 and over.
4.2.3 Adult WEMWBS mean score (age-standardised), 2022, by issues with mouth, teeth or dentures, and sex
In 2022, adults who had any issues with their mouth, teeth or dentures reported lower mental wellbeing on average than those who had no such issues, with mean WEMWBS scores of 41.9 compared with 47.7 respectively.
This pattern was evident for both men and women. There was not a significant difference in average wellbeing by sex among those with issues with the mouth, teeth or dentures.
Table List
Table 4.1 Number of natural teeth/no natural teeth (adults), 2022, by age and sex
Table 4.2 Issues with mouth, teeth or dentures, 2022, by age and sex
Table 4.3 Adult WEMWBS mean score (age-standardised), 2022, by issues with mouth, teeth or dentures, and sex
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