Deficits in perceptions of oral health relative to general health in populations

OBJECTIVE: To compare perceptions of general health versus oral health within two populations. METHODS: Secondary analysis of cross-sectional survey data obtained from representative samples of dentate adults in Australia and the United States. Australian data were collected in the 2002 National Dental Telephone Interview Survey and United States data were from the NHANES, 1988-1994. A stratified analysis compared self-ratings of general and oral health among groups classified by age, socioeconomic status and access to dental care. RESULTS: In Australia, 43.6% rated their dental health 'very good' or 'excellent' whereas 58.6% rated their general health 'very good' or 'excellent'--a deficit of 15.0%. In the US, there was a comparable deficit of 24.2%. The deficit could be explained as a 'generation gap' where oral health ratings of the youngest cohort resembled the general health ratings of middle-aged adults in Australia and retirees in the US. An 'affluence gap' was evident where the oral health ratings of wealthier adults resembled the general health ratings of disadvantaged adults. Among Australians with private dental insurance who had visited a dentist in the past year the oral health deficit was negligible. Similar stratification in the US sample considerably attenuated the deficit. CONCLUSION: There is a deficit in perceived oral health compared with general health at all stages of adulthood and spanning the socioeconomic spectrum. The deficit was diminished among insured adults who had made a dental visit within the preceding year, suggesting that improved access to dental services may help redress the discrepancy.