Red Book

Oral health

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Good oral hygiene and a diet low in sugar help to prevent dental decay and periodontal disease, and improves oral health in children and adults. There is evidence that the use of fluoride in water, or topically, reduces dental decay in children.1–3 Although there is insufficient evidence to screen for oral cancer, opportunistic examination of the mouth and lips is encouraged in increased risk groups.4

Oral health: Identifying risk of dental decay, periodontal disease and oral cancer

Table 11.1

Oral health: Identifying risk of dental decay, periodontal disease and oral cancer

Table 11.2

Table 11.2

Oral health: Preventive interventions


Health inequity

Oral disease is more prevalent among low socioeconomic groups. Significant financial barriers to accessing dental care remain in Australia. People on low incomes are more likely to delay dental visits and less likely to receive appropriate dental care.18

Private dental insurance is associated with higher rates of dental care, but insurance is less common in low income groups or those in regional or remote locations. People who hold healthcare cards are less likely to receive preventive dental care and more likely to receive extractions when visiting the dentist.18,19Aboriginal and Torres Strait Islander peoples are at higher risk of poor oral health.20

  1. Iheozor-Ejiofor Z, Worthington HV, Walsh T, et al. Water fluoridation for the prevention of dental caries. Cochrane Database Syst Rev 2015;6:Cd010856.
  2. McDonagh MS, Whiting PF, Wilson PM, et al. Systematic review of water fluoridation. BMJ 2000;321(7265):855– 59.
  3. World Health Organization. Sugars intake for adults and children. Geneva: WHO, 2015.
  4. US Preventive Services Task Force. The guide to clinical preventive services: Recommendations of the US Preventive Services Task Force. Rockville, MD: USPSTF, 2014 [Accessed 1 November 2015].
  5. National Health and Medical Research Council. Review of water fluoridation and fluoride intake from discretionary fluoride supplements. Canberra: NHMRC, 1999.
  6. Ahovuo-Saloranta A, Forss H, Hiiri A, Nordblad A, Makela M. Pit and fissure sealants versus fluoride varnishes for preventing dental decay in the permanent teeth of children and adolescents. Cochrane Database Syst Rev 2016;1:Cd003067.
  7. Sievers K, Silk H. Fluoride varnish for preventing dental caries in children and adolescents. Am Fam Physician 2016;93(9):743–44.
  8. US Preventive Services Task Force. Oral cancer: Screening. Rockville, MD: USPSTF, 2014 UpdateSummaryFinal/oral-cancer-screening1 [Accessed 1 November 2015].
  9. Smith RA, Cokkinides V, Brooks D, Saslow D, Shah M, Brawley OW. Cancer screening in the United States, 2011: A review of current American Cancer Society guidelines and issues in cancer screening. CA Cancer J Clin 2011;61(1):8–30.
  10. Marinho VC, Higgins JP, Sheiham A, Logan S. Fluoride toothpastes for preventing dental caries in children and adolescents. Cochrane Database Syst Rev 2003;1:Cd002278.
  11. Walsh T, Worthington HV, Glenny AM, Appelbe P, Marinho VC, Shi X. Fluoride toothpastes of different concentrations for preventing dental caries in children and adolescents. Cochrane Database Syst Rev 2010;1:Cd007868.
  12. Marinho VC, Worthington HV, Walsh T, Chong LY. Fluoride gels for preventing dental caries in children and adolescents. Cochrane Database Syst Rev 2015;6:Cd002280.
  13. National Oral Health Promotion Clearing House. Oral health messages for the Australian public. Findings of a national consensus workshop. Aust Dent J 2011;56(3):331–35.
  14. Department of Health. Evidence-based oral health promotion resource. Melbourne: Prevention and Population Health Branch, 2011.
  15. NSW Health. Early childhood oral health guidelines for child health professionals. Sydney: Centre for Oral Health Strategy, 2014 policies/gl/2014/GL2014_020.html [Accessed 21 March 2016].
  16. Sugerman PB, Savage NW. Current concepts in oral cancer. Aust Dent J 1999;44(3):147–56.
  17. Neil A. The extent of water fluoridation coverage in Australia. Aust N Z J Public Health 2011;35(4):392–93.
  18. Sanders A. Social determinants of oral health: Conditions linked to socioeconomic inequalities in oral health in the Australian population. Canberra: Australian Institute of Health and Welfare, 2007.
  19. Chrisopoulos S, Harford J. Oral health and dental care in Australia: Key facts and figures 2012. Canberra: AIHW, 2013.
  20. National Aboriginal Community Controlled Health Organisation and The Royal Australian College of General Practitioners. National guide to a preventive health assessment for Aboriginal and Torres Strait Islander people. 2nd edn. South Melbourne, Vic: RACGP, 2012.
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