Several groups within the Australian population experience a higher burden of oral disease compared to the rest of the population. These inequities arise due to the circumstances in which people live and work, how much they earn, where they live and who they are – the social determinants of health. Inequity takes the form of poorer health status and health outcomes, access to care and self care capacity.

Aboriginal and Torres Strait Islander people

As with other chronic diseases, Aboriginal and Torres Strait Islander peoples experience significantly higher levels of oral disease. Aboriginal and Torres Strait Islander adults have twice the rate of untreated decay, nearly 50% more gum disease than other Australian adults. Aboriginal and Torres Strait Islander children have higher rates of tooth loss, gum disease and untreated decay than other children. Both adults and children are more likely to have unfavourable visiting patterns. [1]

Low Income Australians

Concession card holders (e g pensioner concession cards, healthcare cards) are predominantly low-income earners. Concession card holders are more likely to have unfavourable visiting patterns and higher rates of untreated decay and gum disease.

Amongst those Australian that are ineligible for concession cards but have low incomes Рthe working poor  unfavourable visiting patterns and the associated higher disease rates are more common.

Rural and remote residents

Access to dental care is a significant issue in rural and remote areas. As a result, unfavourable visiting patterns are more common in rural and remote areas. Rates of gum disease, untreated decay and tooth loss are also higher than in metropolitan areas and regional centres.

Other groups

Other groups in society that are marginalised, such as refugees, homeless persons and those with mental health issues, also experience challenges with accessing appropriate oral health care and as a result have poorer oral health than the general population.

The Challenge

Many of the factors contributing to oral health inequities are outside of the scope of the health system to directly affect; examples include the impact of living conditions, access to nutritious foods, and the availability of transport. It is important however that oral health providers work collaboratively to encourage acknowledgement and consideration of these factors in the development of public policy and health service development.

Health service can directly contribute to addressing oral health inequities by identifying service gaps and working with clients, client advocates, governments at all levels and other health care providers to improve engagement, access to services, oral health literacy and outcomes.


[1] Spencer, A.J. and Harford, J. (2008), Improving Oral Health and Dental Care for Australians,Prepared for the NHHRC.