Oral health

Data table

Note

Records where Aboriginal status was not stated were classified as non-Aboriginal. Hospital separations were classified using ICD-9-CM up to 1997-98 and ICD-10-AM from 1998-99 onwards. Rates were age-adjusted using the Australian population as at 30 June 2001. Numbers for 2006-07 include an estimate of the small number of interstate hospitalisations, data for which were unavailable at the time of production.

Source

NSW Admitted Patient Data Collection and ABS population estimates (HOIST). Centre for Epidemiology and Research, NSW Department of Health.

Commentary

Compared with the overall Australian population, Aboriginal children generally have more than twice the caries and a greater proportion of untreated caries, while Aboriginal adults have more missing teeth. Periodontal health is worse among Aboriginal people, with poor periodontal health evident in younger populations (NACOH, 2004).

Oral health in Aboriginal communities, particularly in rural and remote areas, is affected by a number of factors, including water quality and fluoridation, diet, smoking, alcohol consumption, stress, infection, the cost and availability of oral hygiene systems, the availability of dental services and transport over distance to those services that exist (NACOH, 2004).

Oral diseases are associated with cardiovascular disease, cerebrovascular disease, diabetes, preterm and low birth weight babies, aspiration pneumonia, blood-borne disease, infective endocarditis, otitis media, and nutritional deficiencies in children and older adults. A number of these conditions - notably diabetes and cardiovascular disease - are major contributors to the poor health of Aboriginal people and comorbidity with oral disease is common (NACOH, 2004).

In NSW from 1996-97 to 2006-07, the rate of hospitalisation for removal or restoration of teeth in Aboriginal children younger than 15 years was around 20% higher than for non-Aboriginal children. Rates for restoration were higher for non-Aboriginal children than for Aboriginal children, whereas rates for removal were higher for Aboriginal children. The rates were generally similar for males and females, although usually slightly higher for males. Similar patterns were observed when adults were included.

Nationally, the Child Dental Health Survey found that at all ages the proportion of children with caries was higher among Aboriginal than among non-Aboriginal children (Jamieson et al., 2007). The mean number of decayed teeth was also higher among Aboriginal children.

The quality of collection of data on the level of identification of Aboriginal people in health administrative datasets in NSW varies. The AIHW conducted a national validation survey of patients in hospitals in 2007 to provide comparative data for the first time on the level of underestimation of Aboriginal people in hospital data. The results showed that the estimated level of enumeration in hospital admitted patient data in NSW was 88%. Coverage varied by geographic area: Major cities = 81%; Inner regional areas = 89%; Outer regional areas = 95%; and Remote and very remote areas = 100% (AIHW, 2007).

Underenumeration can introduce bias in the study results if it is systematic. There is evidence of bias based on place of residence in hospital data in NSW. Efforts are currently being made in NSW to improve the quality and completeness of Aboriginal identification in health data collections. The linkage of data from various health administarative datasets has the potential to improve 'identification' of Aboriginal records for statistical purposes.

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For more information

Australian Health Ministers' Advisory Committee. Oral health of Australians: National planning for oral health improvement: final report Adelaide: South Australian Department of Human Services, 2001.

National Advisory Committee on Oral Health (NACOH) to Australian Health Ministers' Conference. Healthy mouths healthy lives: Australia's national oral health plan 2004-2013 Adelaide: Government of South Australia, 2004.

Jamieson LM, Armfield JM & Roberts-Thomson KF. Oral health of Aboriginal and Torres Strait Islander children. AIHW cat. no. DEN 167. Dental Statistics and Research Series No. 35. Canberra: Australian Institute of Health and Welfare, 2007. Available at www.adelaide.edu.au/spdent/dsru/pub_frame.html

Australian Bureau of Statistics and Australian Institute of Health and Welfare. The health and welfare of Australia's Aboriginal and Torres Strait Islander peoples, 2008. ABS Cat. No. 4704.0. AIHW Cat. No. IHW 21. Canberra: ABS, 2008. Available at www.abs.gov.au/AUSSTATS/abs@.nsf/mf/4704.0

Statistical Information Management Committee. Out-of-session Agenda item paper number 4/2007. Canberra: AIHW, 2007.

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Copyright notice

This work is copyright NSW Department of Health, 2006. It may be reproduced in whole or in part, subject to the inclusion of an acknowledgement of the source. Commercial usage or sale is prohibited.

Suggested citation

Population Health Division. The health of the people of New South Wales - Report of the Chief Health Officer. Sydney: NSW Department of Health. Available at: www.health.nsw.gov.au/publichealth/chorep/. Accessed (insert date of access).

Produced by

Centre for Epidemiology and Research, Population Health Division, NSW Department of Health.

Last updated on 15 December 2008