Australians born before 1930 lived through the Great Depression and World War II, when oral disease was widespread and mostly treated by extracting teeth. After 1950, dental treatment improved, and more older Australians are able to keep their natural teeth. This is good news, but also means greater oral health needs for the older population in the years ahead.
More natural teeth
Between 1987-88 and 2004-2006, the percentage of Australian adults who had no natural teeth more than halved, from 14.4% to 6.4%.
By 2040, with the passing of older generations, it is expected that only 1% of Australians will have no teeth.
In 2006, 14.9% of Australian adults wore one or two removable dentures. An average of 1.3 missing teeth per person had been replaced, either by wearing a denture or by the presence of a fixed bridge. People born before 1950 had much greater levels of tooth loss and tooth replacement than younger adults.
Tooth loss and tooth replacement were much more frequent among people who were eligible for public dental care, and among people who completed year 9 or less of schooling.
Dental decay and Gum disease
95% of Australian adults born before 1970 had experience of dental decay, and the average number of teeth affected by decay was 24.3 in people born before 1930.
Approximately one-quarter of Australian adults across all generations had untreated tooth decay. But for Australians born pre 1930, 17.3% had untreated decay on exposed root surfaces, compared with 1.5% of those born 1970-1990.
Periodontitis (gum disease) was strongly associated with age, occurring among 60.8% of people aged 75 years. Signs of periodontitis were found in only one or two sites around the mouth, on average, from among the 84 sites measured per person.
Periodontitis was more common among males and those who had completed year 9 or less of schooling, people with no dental insurance, those eligible for public dental care, and people who attended the dentist for treatment of dental problems.
One in five Australian adults (19.7%) additionally had signs of gum inflammation (redness, swelling or bleeding). The frequency of inflammation, which can be a precursor to destructive periodontitis, did not vary meaningfully among generations.
The average number of dental visits by adults per year by increases from early adulthood to a peak in the 55-64 year olds and then declines. The cost of care peaks later, around the 65-74 year age bracket.
The increasing prevalence of chronic disease and the developing evidence supporting links between oral health and chronic disease are significant factors which will impact on demand for care in coming years.
People with chronic disease are less likely to report good oral health than those without a chronic health condition. While there is no overall difference in attendance patterns between those with and without chronic disease, those with some specific conditions, eg stroke or diabetes, are more likely to seek care for a problem rather than a check-up and are more likely to use the public system.
Older Australians living in residential care situations are at greater risk of developing complex oral health problems. This is a result of the multiple general health, functional, cognitive, social and service access challenges facing this group.The role of carers is critical to effective management of oral health in this population.
 Australian Institute of Health and Welfare 2010. Age and the costs of dental care. Research report series no. 48 . Cat. no. DEN 203. Canberra: AIHW.
 Ellershaw A & Spencer A 2011. Dental attendance patterns and oral health status. Dental statistics and research series no. 57. Cat. no. DEN 208. Canberra: AIHW.
 Carter K D, Spencer AJ, Wright C, King L & Chalmers J M 2009. Caring for oral health in Australian residential care. Dental statistics and research series no. 48. Cat. no. DEN 193. Canberra: AIHW