December 12, 2002
The oral health of the Hong Kong population has improved considerably over the years but tooth decay and gum disease are still imminent threats to them.
This remark was made by Dr Joseph Chan of the Department of Health (DH) at a press conference on the Oral Health Survey 2001 Report today (December 12).
The survey was conducted by DH in 2001 on a territory-wide basis with a view to monitoring the oral health status and oral health related behaviour of the community. The findings of the survey would help DH plan and evaluate its oral health programmes.
Speaking at the press conference, Dr Chan said the survey included four key index age groups, i.e. five, 12, 35-44, 65 and above, a criterion which is in line with the World Health Organisation's survey methodology. Nearly 6 000 people were evaluated through clinical examinations and specially designed questionnaires.
Dr Chan said the oral health of the Hong Kong's population showed improvement over the years and was found to be in the same ranking as if not better than most developed countries.
The DMFT index (a globally adopted measurement on the extent and severity of tooth decay) of Hong Kong's 12-year-old students and adults between the ages of 35 to 44 was lower than their counterparts in similar developed countries.
"In fact, among the countries in geographical proximity and comparable economic development to Hong Kong, local adults boasted a zero per cent in terms of total tooth loss. The oral health condition of the 12-year-old is regarded as very good. Their level of tooth decay is actually among the world's lowest," Dr Chan said.
Dr Chan said in term of tooth decay, the percentage of population with decay experience among the 12-year-old children dropped from 60 in 1986 to 37.8 in 2001. For the 35-44 age group, it was 98 in 1991 and 97.5 in 2001.
The five-year-old group also recorded a percentage drop from 63 in 1988 to 51 in 2001.
He attributed the downward trend to the introduction of water fluoridation in 1961, and the wide availability of fluoride-containing toothpaste and its use over the years, resulting in the reduction in the level of tooth decay especially in the younger age population.
"The establishments of the Faculty of Dentistry in the University of Hong Kong and DH's Oral Health Education Unit, as well as the provision of school dental care service by DH from the 1980s are also crucial contributory factors," he said.
However, there is evidence that both tooth decay and gum diseases, which are usually overlooked by Hong Kong people, are still imminent threats. The level of tooth decay and gum disease continued to increase with age and the risk in the development of gum disease was already noticeable at age 12 because of the common occurrence of calculus.
The survey also revealed that about one-third of adults (aged 35-44) had untreated decay.
"Almost half of our adult population had gum disease with the formation of gum pockets, meaning the occurrence of destruction to the tooth-supporting tissue," Dr Chan said.
For five-year-old children, more than 90 per cent of the decayed teeth were left untreated. About 50 per cent of the five-year-old population was affected by tooth decay. Tooth decay was found to be unevenly distributed, with 78% of the decayed teeth being found in 23.6% of children. This sub-group of children were considered as high-risk in developing more decay.
As for the older persons (aged 65-74), Dr Chan said more than half of the non-institutionalised older persons (NOP) had untreated tooth decay, and among them 40.6 per cent had decay on root surface. Both gum pockets and gum recession were common. Gum pockets were also found in more than half of them.
Tooth loss was common among the institutionalized older persons (IOP), with 27% of them having no teeth at all.
Dr Frankie So, who was also at the press conference, said misconceptions about oral diseases were common among all the age groups interviewed. He added that inadequate oral-related behaviour generally lead to poor oral health.
"Although toothbrushing was mostly practised by the local population, interdental cleaning such as flossing was not a social norm. Furthermore, only a small number of parents regularly helped their five-year-old children brush their teeth."
"Some parents were even not aware of their children's oral health problems. Among children whose parents rated them as having good oral health, almost 40 per cent actually had tooth decay, and up to 10 per cent of them had more than three decayed teeth," Dr So noted.
"Effective teeth cleaning practices need to be reinforced by all age groups," he stressed.
He pointed out that the habit of seeking regular dental check-up was also not common. Of all the groups surveyed, the adults fared better, but still almost three out of four adults did not seek regular dental check-up.
For the 12-year-old, the use of oral health care services dropped dramatically after they entered secondary school. Only 20.9 per cent of secondary school students reported the seeking of dental check-up, Dr So said.
"Short of this prescribed habit, the opportunities for professionally applied prevention therapy, as well as early diagnosis and early intervention would not be possible," Dr So said.
Frequent snacking and smoking are also risk factors to oral health. The survey indicated that snacking habit was more common among the five and 12-year olds than other age groups. Smoking habit was reported by 17 per cent of adults and 21 per cent NOP.
"Smoking is associated with a higher risk of developing destructive gum disease and oral cancer. Any food substances containing sugar, either artificially added or naturally occurring, can cause tooth decay. Frequency of intake is more important than quantity consumed with respect to tooth decay."
The adults in general did not perceive the need for regular dental check-ups. Most of them had experienced various oral health problems such as bad breath, bleeding gums, sensitivity to hot and cold, and pain that disturbed sleeping. However, the percentages of them seeking dental treatment for these conditions were relatively low (four to 47 per cent). More than half of them did not take any action even when their teeth were sensitive to hot or cold, or when they suffer from bleeding gums or mobile teeth.
The survey also showed that many people, especially the elderly group, wrongfully considered tooth loss as a natural eventuality of life.
"To 41 per cent of the adults, 63 per cent of NOP and 70 per cent of IOP, tooth loss was considered as part and parcel of aging."
Dr So stressed that tooth loss at old age was definitely not a natural eventuality in life. "If proper actions are to be initiated today, teeth can stay with you for life."
"Attaining optimal level of oral health at all ages is important and requires conscious efforts and self-care at individual level."
"Prevention is the key to better oral health. In order to reduce the undesirable consequence of tooth loss, it is essential to prevent the onset of new diseases and the deterioration of existing problem," Dr So said.
He reminded members of the public to:
perform teeth cleaning preferably twice a day, by proper toothbrushing with fluoride-containing toothpaste and appropriate interdental cleaning;
seek regular dental check-up for prevention, early detection and management of oral health problems;
Dr Chan said DH would intensify its educational and promotional efforts together with the dental profession and relevant stakeholders with a viewing to further improving the oral health of the community.
The survey report has been uploaded onto the oral health website. ( http://www.info.gov.hk/tooth_club )