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The level of oral health in Hong Kong in terms of tooth loss is among the best when compared with levels in many developed countries, as revealed in the Oral Health Survey (OHS) 2011 published by the Department of Health (DH) today (December 27).
"Tooth loss is not necessarily a part of ageing. However, daily toothbrushing is not adequate for preventing dental disease. People should improve their oral self-care and seek professional dental care properly," a spokesman for the DH said.
The DH conducted the second territory-wide OHS in 2011, 10 years after the first survey in 2001, to monitor the oral health conditions as well as the oral health behaviours of the community.
Similar to the survey 10 years earlier, the OHS 2011 was conducted in line with the survey methodology of the World Health Organization, and four key index ages and age groups were selected, i.e. 5, 12, 35 to 44, and 65 and above. Functionally dependent older persons requiring additional support in their daily activities, i.e. users aged 65 and above of the Social Welfare Department long-term care (LTC) services, were also included. In this survey, nearly 8 000 people were evaluated through clinical examinations and specially designed questionnaires.
Compared with the situation 10 years earlier, the degree of tooth loss among all these age groups improved. In addition, no toothless adults aged 35 to 44 were found in this survey, and the proportion of non-institutionalised older persons (NOPs) aged 65 to 74 with no teeth dropped from 8.6 per cent to 5.6 per cent.
The proportion of the population with tooth decay declined. The drop among 12-year-old students was the most significant (37.8 per cent in 2001 to 22.6 per cent in 2011).
Improvement was noted in the gum condition of the 12-year-old students (percentage with healthy gums: 5.5 per cent in 2001 and 13.8 per cent in 2011). However, gum disease was still common among adults and NOPs. About 40 per cent of adults and about 60 per cent of NOPs had gum pockets.
Regarding their toothbrushing habits, a higher proportion of 5-year-old children brushed their teeth twice or more daily (54.4 per cent in 2001 and 74.5 per cent in 2011), and a higher proportion had parental assistance when they brushed (69.2 per cent in 2001 and 90.2 per cent in 2011). Although 67.1 per cent to 80.7 per cent of the other age groups brushed their teeth twice or more daily, only 6.8 per cent to 15.4 per cent of them had a daily interdental cleaning habit. The current tooth cleaning practice was also not effective in removing plaque to prevent gum disease. More than 97 per cent of adults and NOPs had gum bleeding and more than 80 per cent had gum bleeding around half or more of their teeth.
The dental checkup rate of 5-year-old children was the lowest (10 per cent) among the age groups. Some parents mistook that the oral health of their children had been good, and this could result in many tooth decay cases being undetected and untreated. It was found that up to 92 per cent of the decayed teeth among the 5-year-old children were untreated. Regarding other age groups, 56.3 per cent of adults and 22.3 per cent of NOPs had dental checkups regularly. Still, a sizeable proportion had no such habit.
The survey also found that the adult and older populations in Hong Kong tended to ignore the symptoms of oral diseases and delayed the seeking of dental care, even for severe problems such as toothache that disturbed sleep. Such delay would only result in further deterioration leading to more suffering, more complex and costly treatment, or even extraction of teeth.
Compared with the situation for other age groups, the tooth loss conditions of LTC users were the worst. About 20 per cent to 30 per cent of LTC users had no teeth at all. Almost all of them had an experience of tooth decay. The present survey revealed that LTC users perceived functional problems of unsatisfactory appearance, difficulties in chewing and discomfort in eating. They also perceived a need to visit a dentist. Yet regular dental checkups were uncommon (0.7 per cent to 7.9 per cent) and relatively few LTC users (25.6 per cent to 36.5 per cent) had visited a dentist in the previous three years.
The OHS 2011 also showed that a large proportion of the population was still unaware of the fact that frequent eating or drinking is a risk factor for tooth decay and could not relate smoking to gum disease. An increased proportion of students and their parents did not know whether fluoride was present in their toothpaste. Therefore, the harmful effects of frequent eating and drinking on the teeth and smoking on the gums as well as the concept of use of fluoride toothpaste should be reinforced in health education.
In order to have dentition good enough for physiological and social needs at old age, effective prevention through good oral self-care complemented with professional dental care and a good lifestyle should start at a young age. Members of the public are recommended to:
(1) brush teeth twice daily with fluoride toothpaste using proper toothbrushing technique;
(2) perform interdental cleaning daily with dental floss or an interdental brush;
(3) make use of oral health care services, especially seeking regular dental checkups for early detection and management of oral health problems;
(4) adopt good dietary habits by reducing the frequency of intake of food and drinks, especially those with sugar, and by seeking medical advice for special dietary requirements; and
(5) refrain from smoking or quit smoking.
"In this connection, the DH will intensify the education and promotion efforts to raise the oral health awareness of members of the public and to motivate them to adopt good oral health habits. It should be emphasised that a dentist is the partner for oral disease prevention. A dentist can provide individual guidance and advice on tooth cleaning methods as well as dietary and other oral health-related habits," the spokesman said.
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"Normally, adults and NOPs are the main caregivers of their families. Their proper partnership with dentists will not only help them to improve their own oral health, but also the oral health of those whom they are taking care of. Accordingly, the concept of partnership with a dentist should be promoted," the spokesman added.
In conclusion, this survey provides reliable and useful information to the dental profession and relevant stakeholders for planning future oral health care development collaboratively so as to promote better oral health in the Hong Kong community.
The full report and the highlight version of the OHS 2011 can be downloaded from the DH's Oral Health Education Unit website (www.toothclub.gov.hk/en/en_home_06.htm).
Ends/Friday, December 27, 2013
Issued at HKT 14:30
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